Provider Demographics
NPI:1770766792
Name:PRIMARY PLUS HOME HEALTH, INC.
Entity type:Organization
Organization Name:PRIMARY PLUS HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:AVAGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:818-655-0411
Mailing Address - Street 1:12509 OXNARD ST STE 215
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-4443
Mailing Address - Country:US
Mailing Address - Phone:818-655-0411
Mailing Address - Fax:818-655-0421
Practice Address - Street 1:12509 OXNARD ST STE 215
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-4443
Practice Address - Country:US
Practice Address - Phone:818-655-0411
Practice Address - Fax:818-655-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001027251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health