Organization
EMEDASSIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RANDA BALLOUT (PRESIDENT)
(877) 454-4868
Entity
Organization
Contact information
Practice address
17402 CHATSWORTH STREET, ST 201, GRANADA HILLS, CA 91344-7619
(877) 454-4868
(877) 321-2298
Mailing address
17402 CHATSWORTH STREET, ST 201, GRANADA HILLS, CA 91344-7619
(877) 454-4868
(877) 321-2298
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
291U00000X
Clinical Medical Laboratory
Primary
CA150503
CA
Other
Enumeration date
07/02/2014
Last updated
10/06/2019
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