Central Coast Home Health, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

54252 Issued in CA

Legal business name

CENTRAL COAST HOME HEALTH, INC.

Practice address

243 Granada Dr Ste a
Suite a
San Luis Obispo, CA 93401-7336

Phone

(805) 540-2780

Fax

(805) 540-2158

NPI assigned

Apr 26, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Brian Pritt

Title

President

Phone

(805) 543-2244

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Pharma 101 Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Central Coast Home Health Inc

  • Home Health Agency
  • San Luis Obispo, CA
  • NPI 1609044924

  9638257108

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Central Coast Home Health Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Central Coast Home Health Inc

  • Durable Medical Equipment & Medical Supplies
  • San Luis Obispo, CA
  • NPI 1598339822
  NPD tax ID
• Central Coast Home Health Inc

  • Home Health Agency
  • San Luis Obispo, CA
  • NPI 1609044924
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kailey Marie Buczek, PT, DPT

  • Physical Therapist
  • San Luis Obispo, CA
  • NPI 1689497810
  NPD (past)
• Brooke Cone, ASW

  • Social Worker
  • San Luis Obispo, CA
  • NPI 1124224563
  NPD (past)
• Jared Francis Yankovich

  • Physical Therapist
  • San Luis Obispo, CA
  • NPI 1104641877
  NPD (past)

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1376998401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 GRANADA DR",
            "address_2": "SUITE D",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017340",
            "telephone_number": "805-540-2780",
            "fax_number": "805-540-2158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 GRANADA DR STE A",
            "address_2": "SUITE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017336",
            "telephone_number": "805-540-2780",
            "fax_number": "805-540-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL COAST HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-26",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "PRITT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-543-2244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "CA",
            "license": "54252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159768",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharma 101",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Pharma 101",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Central Coast Eye Associates Inc
• Central Coast Eye Surgery, Inc., a Professional Medical Corporation
• Central Coast Eye, Inc., a Professional Medical Corporation
• Central Coast Home Health Inc
• Central Coast Home Health Inc
• Central Coast Imaging, P.C.-Raytel Medical Imaging
• Central Coast Institute for Plastic Surgery, AMC
• Central Coast Lymphedema
• Central Coast Lymphedema Therapy
• Central Coast Maternal-Fetal Medicine

• Long Term Care Pharmacy in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Long Term Care Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.