Provider Demographics
NPI:1477807006
Name:ASHLI HEALTHCARE INC
Entity Type:Organization
Organization Name:ASHLI HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HERIBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-979-4619
Mailing Address - Street 1:2201 ZEUS COURT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6867
Mailing Address - Country:US
Mailing Address - Phone:888-831-7977
Mailing Address - Fax:888-831-0909
Practice Address - Street 1:323 W CROMWELL AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-5844
Practice Address - Country:US
Practice Address - Phone:888-831-7977
Practice Address - Fax:888-831-0909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLI HEALTHCARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-05
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6303150002Medicare NSC