Provider Demographics
NPI:1275726051
Name:HOME HEALTH CARE PROVIDER INC.
Entity Type:Organization
Organization Name:HOME HEALTH CARE PROVIDER INC.
Other - Org Name:DBA: HOME HEALTH CARE REGISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:ORTANEZ
Authorized Official - Last Name:EGGERT
Authorized Official - Suffix:
Authorized Official - Credentials:AMA
Authorized Official - Phone:510-790-1930
Mailing Address - Street 1:949 CASHEW WAY
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-2647
Mailing Address - Country:US
Mailing Address - Phone:510-790-1930
Mailing Address - Fax:
Practice Address - Street 1:949 CASHEW WAY
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-2647
Practice Address - Country:US
Practice Address - Phone:510-790-1930
Practice Address - Fax:510-790-0782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA038521251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health