Provider Demographics
NPI:1073769543
Name:ANX HOME HEALTHCARE
Entity type:Organization
Organization Name:ANX HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
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,BSN,CWCN
Authorized Official - Phone:650-271-5721
Mailing Address - Street 1:455 HICKEY BLVD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2629
Mailing Address - Country:US
Mailing Address - Phone:650-991-5177
Mailing Address - Fax:650-991-5178
Practice Address - Street 1:455 HICKEY BLVD
Practice Address - Street 2:SUITE 415
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2629
Practice Address - Country:US
Practice Address - Phone:650-991-5177
Practice Address - Fax:650-991-5178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059071Medicare Oscar/Certification