Provider Demographics
NPI:1457715484
Name:ANX HOME HEALTHCARE NURSING - EASTBAY INC.
Entity Type:Organization
Organization Name:ANX HOME HEALTHCARE NURSING - EASTBAY INC.
Other - Org Name:ANX HOME HEALTHCARE EASTBAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS ALLANDALE
Authorized Official - Middle Name:LAGROSAS
Authorized Official - Last Name:ROCAS
Authorized Official - Suffix:III
Authorized Official - Credentials:RN
Authorized Official - Phone:650-271-5721
Mailing Address - Street 1:925 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 103A
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3875
Mailing Address - Country:US
Mailing Address - Phone:650-271-5721
Mailing Address - Fax:
Practice Address - Street 1:455 HICKEY BOULEVARD
Practice Address - Street 2:STE 415
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2630
Practice Address - Country:US
Practice Address - Phone:650-271-5721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health