Provider Demographics
NPI:1588788095
Name:MEDHEALTH NURSING, LLC
Entity type:Organization
Organization Name:MEDHEALTH NURSING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM/DIR. PATIENT CARE SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:CEA
Authorized Official - Last Name:MALLARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, BSN, RN
Authorized Official - Phone:510-512-8289
Mailing Address - Street 1:340 LAKE MERCED BLVD APT 21
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-3124
Mailing Address - Country:US
Mailing Address - Phone:510-512-8289
Mailing Address - Fax:650-994-5320
Practice Address - Street 1:340 LAKE MERCED BLVD APT 21
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-3124
Practice Address - Country:US
Practice Address - Phone:510-512-8289
Practice Address - Fax:650-994-5320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD3982767OtherDRIVER'S LICENSE