Provider Demographics
NPI:1821265604
Name:MED CARE PLUS INC
Entity Type:Organization
Organization Name:MED CARE PLUS INC
Other - Org Name:MED CARE PLUS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHN
Authorized Official - Phone:626-796-9341
Mailing Address - Street 1:490 S ROSEMEAD BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-4962
Mailing Address - Country:US
Mailing Address - Phone:626-796-9341
Mailing Address - Fax:626-796-9499
Practice Address - Street 1:490 S ROSEMEAD BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-4962
Practice Address - Country:US
Practice Address - Phone:626-796-9341
Practice Address - Fax:626-796-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000325251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA550000325OtherDEPARTMENT OF HEALTH SERVICES LICENSE NUMBER
CA551525Medicare Oscar/Certification