1134779788 NPI number — THERAPYMED HOME HEALTH SERVICES

Table of content: (NPI 1134779788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134779788 NPI number — THERAPYMED HOME HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPYMED HOME HEALTH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134779788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
151 N SUNRISE AVE
Provider Second Line Business Mailing Address:
SUITE 1116
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95661
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
279-900-8127
Provider Business Mailing Address Fax Number:
279-900-8129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 N SUNRISE AVE
Provider Second Line Business Practice Location Address:
SUITE 1116
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
279-900-8127
Provider Business Practice Location Address Fax Number:
279-900-8129
Provider Enumeration Date:
09/16/2019

Additional Information

Authorized Official

Authorized Official Last Name:
DE GUZMAN
Authorized Official First Name:
JUNDER JOE
Authorized Official Middle Name:
B
Authorized Official Title or Position:
CEO/DIRECTOR/ADMINISTRATOR
Authorized Official Telephone Number:
650-861-1496

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com