Provider Demographics
NPI:1780194159
Name:PROMED HEALTH PROVIDERS, INC.
Entity Type:Organization
Organization Name:PROMED HEALTH PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POGOSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-392-8080
Mailing Address - Street 1:1614 VICTORY BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-3830
Mailing Address - Country:US
Mailing Address - Phone:818-392-8080
Mailing Address - Fax:
Practice Address - Street 1:1614 VICTORY BLVD STE 104
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-3830
Practice Address - Country:US
Practice Address - Phone:818-392-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health