# FORMAL HOME HEALTH INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922688050
- **Authorized official:** EDGAR POGHOSYAN (CEO)
- **Authorized official phone:** (626) 800-0114

## Contact information

- **Practice address:** 2060 HUNTINGTON DR STE 10B, SAN MARINO, CA 91108-2044
- **Practice address phone:** (626) 800-0114
- **Mailing address:** 2060 HUNTINGTON DR STE 10B, SAN MARINO, CA 91108-2044

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/13/2021
- **Last updated:** 04/20/2021