Provider Demographics
NPI:1598406571
Name:PM HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:PM HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-256-0240
Mailing Address - Street 1:13641 CENTRAL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-5133
Mailing Address - Country:US
Mailing Address - Phone:909-256-0240
Mailing Address - Fax:909-867-5007
Practice Address - Street 1:13641 CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5133
Practice Address - Country:US
Practice Address - Phone:909-256-0240
Practice Address - Fax:909-867-5007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care