Provider Demographics
NPI:1154560654
Name:AMAX CARE SERVICES, INC.
Entity type:Organization
Organization Name:AMAX CARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MEHRANGIZ MERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARIFZAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-951-0616
Mailing Address - Street 1:936 CRENSHAW BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1949
Mailing Address - Country:US
Mailing Address - Phone:323-951-0616
Mailing Address - Fax:323-951-4993
Practice Address - Street 1:936 CRENSHAW BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1949
Practice Address - Country:US
Practice Address - Phone:323-951-0616
Practice Address - Fax:323-951-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-07
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059434Medicare Oscar/Certification