Provider Demographics
NPI:1972179067
Name:MEDLINE HOME CARE
Entity Type:Organization
Organization Name:MEDLINE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ASHKHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-838-7314
Mailing Address - Street 1:1480 COLORADO BLVD STE 255A
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2357
Mailing Address - Country:US
Mailing Address - Phone:818-838-7314
Mailing Address - Fax:818-839-5876
Practice Address - Street 1:1480 COLORADO BLVD STE 255A
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2357
Practice Address - Country:US
Practice Address - Phone:818-838-7314
Practice Address - Fax:818-839-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health