Provider Demographics
NPI:1285080150
Name:MEDIMAX HEALTHCARE, INC.
Entity type:Organization
Organization Name:MEDIMAX HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUKASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-904-0608
Mailing Address - Street 1:15760 VENTURA BLVD
Mailing Address - Street 2:SUITE 2030
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-3000
Mailing Address - Country:US
Mailing Address - Phone:805-904-0608
Mailing Address - Fax:
Practice Address - Street 1:15760 VENTURA BLVD
Practice Address - Street 2:SUITE 2030
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-3000
Practice Address - Country:US
Practice Address - Phone:805-904-0608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health