Provider Demographics
NPI:1972830586
Name:MEDROSE HOME HEALTH CARE
Entity Type:Organization
Organization Name:MEDROSE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARAULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-280-0908
Mailing Address - Street 1:9350 FLAIR DR STE 108
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2828
Mailing Address - Country:US
Mailing Address - Phone:626-280-0908
Mailing Address - Fax:
Practice Address - Street 1:9350 FLAIR DR STE 108
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2828
Practice Address - Country:US
Practice Address - Phone:626-280-0908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health