Promed Health Providers, Inc.
Organization Active NPI Home Health Agency · Glendale, CA
NPI 1780194159 · NPPES record last updated Oct 11, 2017
Key facts
- NPI
- 1780194159
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- PROMED HEALTH PROVIDERS, INC.
- Practice address
- 1614 Victory Blvd Ste 104
Glendale, CA 91201-3830 - Phone
- (818) 392-8080
- NPI assigned
- Oct 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Arman Pogosian
- Title
- President/Ceo
- Phone
- (818) 392-8080
Affiliated clinicians 1
-
Jin Hee Kim, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Promed Health Providers, Inc
- Overall star rating
- ★★☆☆☆ 2 of 5
- Ownership
- Proprietary
- Certified
- Dec 20, 2019
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Home health agency certification: CCN 559127
- Legal name
- PROMED HEALTH PROVIDERS INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 20, 2019
- Last certification
- Dec 20, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 13, 2017 in CA
- Enrollment address
- 1614 Victory Blvd
Ste 104
Glendale, CA 91201-3830
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Mari Mara Pogosian |
W-2 Managing Employee |
Nov 13, 2023 | |
| Arman Pogosian |
5% Or Greater Direct Ownership Interest |
Jun 15, 2023 | 100% |
| Corporate Officer |
Jun 15, 2023 | 100% | |
| Corporate Director |
Jun 15, 2023 | 100% | |
| W-2 Managing Employee |
Jun 15, 2023 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191003003338 | CA | Part a Provider - Home Health Agency | 8729319868 | Practice locations: Glendale, CA |
National Provider Directory
Locations
1614 Victory Blvd
Ste 104
Glendale, CA 91201
Phone (818) 392-8080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
1614 Victory Blvd Ste 104
Glendale, CA 91201-3830
Mailing address
1614 Victory Blvd Ste 104
Glendale, CA 91201-3830
Phone (818) 392-8080
Other providers in Glendale, CA
- Progress Hospice Care
- Progressive Home Health Care, Inc.
- Progressive Medical Group
- Prohealth Partners a Medical Group Inc
- Prohealth-Glendale Occupational Medical GRP.
- Promise Home Health Care
- Prompt Home Care Inc
- Promptcare Health Services Inc.
- Proper Care Palliative & Hospice
- Prospect Hospice Care, Inc.
All providers in Glendale, CA · Home Health Agency in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.