NPIMap

Organization Active NPI

Medicure Health Services, Inc.

  • Community/Behavioral Health Agency
  • Los Angeles, CA
National Provider Identifier
1942550074
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
190636AN Issued in CA
Legal business name
MEDICURE HEALTH SERVICES, INC.
Practice address
1316 S Union Ave
Los Angeles, CA 90015-2712
Phone
(323) 295-1136
Fax
(323) 295-1071
NPI assigned
Sep 17, 2012
Organization subpart
Yes
Parent organization
MEDI-CURE HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Authorized official

Name
Dr. Josephine C. Kannike-Martins, PHD., RD
Title
Executive Director
Phone
(323) 295-1136

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 190636AN CA Primary

Addresses

Primary practice location

1316 S Union Ave
Los Angeles, CA 90015-2712

Mailing address

3756 Santa Rosalia Dr Ste 417
Los Angeles, CA 90008-3614
Phone (323) 295-1136

Other names 1

  • Public Health Foundation Enterprises, Inc (Aztecs Rising) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medi-Cure Health Services Inc15 organizations share this tax ID, including this one
Part of
Medi-Cure Health Services Inc

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1942550074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR STE 417",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083614",
            "telephone_number": "323-295-1136",
            "fax_number": "323-295-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 S UNION AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152712",
            "telephone_number": "323-295-1136",
            "fax_number": "323-295-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICURE HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDI-CURE HEALTH SERVICES, INC.",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "KANNIKE-MARTINS",
        "authorized_official_first_name": "JOSEPHINE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "323-295-1136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD., RD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "190636AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Public Health Foundation Enterprises, Inc (Aztecs Rising)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.