Provider Demographics
NPI:1851559660
Name:MEDICO HOME HEALTH, INC.
Entity Type:Organization
Organization Name:MEDICO HOME HEALTH, INC.
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:510-926-7289
Mailing Address - Street 1:11501 DUBLIN BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2826
Mailing Address - Country:US
Mailing Address - Phone:209-835-1256
Mailing Address - Fax:209-839-0731
Practice Address - Street 1:11501 DUBLIN BLVD
Practice Address - Street 2:SUITE #201
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2826
Practice Address - Country:US
Practice Address - Phone:209-835-1256
Practice Address - Fax:209-839-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health