Provider Demographics
NPI:1427641612
Name:HEALMARK LLC
Entity type:Organization
Organization Name:HEALMARK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHIMDIADI
Authorized Official - Middle Name:I
Authorized Official - Last Name:AZUBUIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-208-3481
Mailing Address - Street 1:28659 VISTA MADERA
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-0871
Mailing Address - Country:US
Mailing Address - Phone:562-208-3481
Mailing Address - Fax:
Practice Address - Street 1:115 PINE AVE STE 620
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4477
Practice Address - Country:US
Practice Address - Phone:310-691-3880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based