Medline Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MEDLINE HOME HEALTH, INC.

Practice address

13746 Victory Blvd Ste 300
Van Nuys, CA 91401-6725

Phone

(818) 809-2323

Fax

(818) 809-2288

NPI assigned

Mar 21, 2019

Organization subpart

No

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

Authorized official

Name

Edgar Bagumian

Title

Ceo

Phone

(818) 809-2323

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 757054

Legal name

MEDLINE HOME HEALTH INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 23, 2022

Last certification

Mar 31, 2022

Organization structure

CorporationProprietary

Enrollment address

13746 Victory Blvd
Ste 300
Van Nuys, CA 91401-6725

Listed as

Medline Home Health, Inc.CCN 757054 · All quality measures

Ownership

-

Certified

Apr 23, 2022

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1891255329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13746 VICTORY BLVD STE 300",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914016725",
            "telephone_number": "818-809-2323",
            "fax_number": "818-809-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13746 VICTORY BLVD STE 300",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914016725",
            "telephone_number": "818-809-2323",
            "fax_number": "818-809-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINE HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-21",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "BAGUMIAN",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-809-2323"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaylene Rae Medina
• Jennifer Medina
• Medlife Home Care Inc
• Medlife Hospice, Inc.
• Medline Home Health Care,Inc.
• Medlink Mobile
• Medplus Home Health,Inc.
• Medpro Care Inc.
• Medprof Home Health Care, Inc.
• Medtech, Inc

• Home Health Agency in Van Nuys, CA
• Providers in Van Nuys, 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 Mar 21, 2019; 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.