Edmar Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EDMAR HOME HEALTH CARE INC

Practice address

12444 Victory Blvd Ste 301-Z
North Hollywood, CA 91606-3199

Phone

(747) 877-2770

Fax

(747) 877-2771

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Gayane Sardaryan

Title

Cfo,Ceo,Secretary

Phone

(747) 877-2770

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757765

Legal name

EDMAR HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 2, 2024

Last certification

Jun 20, 2024

Organization structure

CorporationProprietary

Enrollment address

6708 Foothill Blvd
Ste 102
Tujunga, CA 91042-2743

Listed as

Edmar Home Health Care IncCCN 757765

Ownership

-

Certified

Aug 2, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1821733072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12444 VICTORY BLVD STE 301-Z",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063199",
            "telephone_number": "747-877-2770",
            "fax_number": "747-877-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12444 VICTORY BLVD STE 301-Z",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063199",
            "telephone_number": "747-877-2770",
            "fax_number": "747-877-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMAR HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "SARDARYAN",
        "authorized_official_first_name": "GAYANE",
        "authorized_official_title_or_position": "CFO,CEO,SECRETARY",
        "authorized_official_telephone_number": "747-877-2770"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.