Provider Demographics
NPI:1407449127
Name:ROSA BLUE HOME HEALTH . LLC
Entity Type:Organization
Organization Name:ROSA BLUE HOME HEALTH . LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADWOA SERWA
Authorized Official - Middle Name:
Authorized Official - Last Name:OSEI NYARKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-587-0957
Mailing Address - Street 1:6400 E WASHINGTON BLVD.
Mailing Address - Street 2:107A
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040
Mailing Address - Country:US
Mailing Address - Phone:661-313-9592
Mailing Address - Fax:
Practice Address - Street 1:6400 E WASHINGTON BLVD.
Practice Address - Street 2:107A
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040
Practice Address - Country:US
Practice Address - Phone:661-313-9592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies