Pristine Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRISTINE HOME HEALTH CARE INC

Practice address

9087 Arrow Rte Ste 248
Rancho Cucamonga, CA 91730-4488

Phone

(909) 481-3463

Fax

(909) 481-3473

NPI assigned

Oct 8, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph Ivoko

Title

Owner

Phone

(310) 864-6065

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757446

Legal name

PRISTINE HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 27, 2023

Last certification

Apr 14, 2023

Organization structure

CorporationProprietary

Incorporated

Nov 1, 2018 in CA

Enrollment address

9087 Arrow Rte
Ste 248
Rancho Cucamonga, CA 91730-4488

Listed as

Pristine Home Health Care IncCCN 757446

Ownership

-

Certified

Apr 27, 2023

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1225635642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9087 ARROW RTE STE 248",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304488",
            "telephone_number": "909-481-3463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9087 ARROW RTE STE 248",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304488",
            "telephone_number": "909-481-3463",
            "fax_number": "909-481-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISTINE HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "IVOKO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-864-6065"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.