Provider Demographics
NPI:1528200425
Name:PATRIOT HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:PATRIOT HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ACHOT
Authorized Official - Middle Name:
Authorized Official - Last Name:MKRTCHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-551-0757
Mailing Address - Street 1:440 W COLORADO ST
Mailing Address - Street 2:STE 215
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1541
Mailing Address - Country:US
Mailing Address - Phone:818-551-0757
Mailing Address - Fax:818-551-0304
Practice Address - Street 1:440 W COLORADO ST
Practice Address - Street 2:STE 215
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1541
Practice Address - Country:US
Practice Address - Phone:818-551-0757
Practice Address - Fax:818-551-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001381251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059318Medicare Oscar/Certification