Organization
KERN HOME HEALTH RESOURCES
Active
Parent organization
KERN HOME HEALTH RESOURCES
Other names
Coram Healthcare
Organization subpart
Yes
Provider details
NPI number
Legal business name
KERN HOME HEALTH RESOURCES
Authorized official
VITO PONZIO, JR. (SR VP)
(303) 672-8631
Entity
Organization
Contact information
Practice address
3101 SILLECT AVE, #109, BAKERSFIELD, CA 93308-6348
(661) 325-8326
(661) 325-6509
Mailing address
1675 BROADWAY, SUITE 900, DENVER, CO 80202-4675
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
120000325
CA
251F00000X
Home Infusion Agency
120000325
CA
261QI0500X
Infusion Therapy Clinic/Center
—
CA
332B00000X
Durable Medical Equipment & Medical Supplies
-PHY48940
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHY 41725
CA
333600000X
Pharmacy
PHY 41725
CA
3336C0003X
Community/Retail Pharmacy
PHY 41725
CA
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHY 41725
CA
3336M0002X
Mail Order Pharmacy
PHY 41725
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-PHY48940
PHARMACY LICENSE
CA
01
—
0522474
NCPDP
—
01
—
120000325
HOME HEALTH AGENCY
CA
05
—
PHA417250
—
CA
Enumeration date
05/11/2006
Last updated
03/07/2023
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