Provider Demographics
NPI:1750861746
Name:ASCLEPIUS HEALTHCARE
Entity Type:Organization
Organization Name:ASCLEPIUS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SAMSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NDUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-202-3006
Mailing Address - Street 1:267 MONUMENT PKWY
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-5526
Mailing Address - Country:US
Mailing Address - Phone:626-202-3006
Mailing Address - Fax:
Practice Address - Street 1:267 MONUMENT PKWY
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-5526
Practice Address - Country:US
Practice Address - Phone:626-202-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-18
Last Update Date:2018-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMealsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)