Formal Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FORMAL HOME HEALTH INC

Practice address

2060 Huntington Dr Ste 10B
San Marino, CA 91108-2044

Phone

(626) 800-0114

NPI assigned

Apr 13, 2021

Last updated

Apr 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edgar Poghosyan

Title

Ceo

Phone

(626) 800-0114

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618876800000",
    "number": "1922688050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 HUNTINGTON DR STE 10B",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 HUNTINGTON DR STE 10B",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082044",
            "telephone_number": "626-800-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMAL HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A",
        "authorized_official_last_name": "POGHOSYAN",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "626-800-0114"
    },
    "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 San Marino, CA
• Providers in San Marino, 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 Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.