1699775478 NPI number — HOMESTAR MED EQUIP & INF SVS

Table of content: (NPI 1699775478)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699775478 NPI number — HOMESTAR MED EQUIP & INF SVS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOMESTAR MED EQUIP & INF SVS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HOMESTAR MEDICAL EQUIPMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699775478
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
77 SOUTH COMMERCE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-419-7600
Provider Business Mailing Address Fax Number:
888-668-0172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 S COMMERCE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-8917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-419-7600
Provider Business Practice Location Address Fax Number:
888-662-0172
Provider Enumeration Date:
07/22/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DESARRO
Authorized Official First Name:
DOMINICK
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
610-419-7610

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  1000002573 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BP3500X , with the licence number: 1000002573 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 1000002573 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)