Provider Demographics
NPI:1629348669
Name:EMERALD TRIUNE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:EMERALD TRIUNE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVY-EILEEN
Authorized Official - Middle Name:MEDINA
Authorized Official - Last Name:SAMOY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:760-294-9680
Mailing Address - Street 1:330 W FELICITA AVE
Mailing Address - Street 2:STE. D6
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6533
Mailing Address - Country:US
Mailing Address - Phone:760-294-9680
Mailing Address - Fax:760-797-1860
Practice Address - Street 1:330 W FELICITA AVE
Practice Address - Street 2:STE. D6
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6533
Practice Address - Country:US
Practice Address - Phone:760-294-9680
Practice Address - Fax:760-797-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059493Medicare Oscar/Certification