Provider Demographics
NPI:1245779461
Name:MED GROUP HOME HEALTH CARE INC.
Entity type:Organization
Organization Name:MED GROUP HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MELKUMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-210-5509
Mailing Address - Street 1:1633 ERRINGER RD
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3583
Mailing Address - Country:US
Mailing Address - Phone:805-210-5509
Mailing Address - Fax:805-210-5548
Practice Address - Street 1:1633 ERRINGER RD
Practice Address - Street 2:SUITE 201A
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3583
Practice Address - Country:US
Practice Address - Phone:805-210-5509
Practice Address - Fax:805-210-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion