Intracommunity Home Care Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

100217 Issued in CA

Legal business name

INTRACOMMUNITY HOME CARE INC

Practice address

610 S Glendale Ave
Glendale, CA 91205

Phone

(818) 500-9014

Fax

(818) 409-9300

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kingsley Rajah

Title

Owner President

Phone

(818) 500-9014

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962506535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-500-9014",
            "fax_number": "818-409-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-500-9014",
            "fax_number": "818-409-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRACOMMUNITY HOME CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAJAH",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_title_or_position": "OWNER  PRESIDENT",
        "authorized_official_telephone_number": "818-500-9014",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "100217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DMEO1457F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Glendale, CA
• Providers in Glendale, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.