1265415368 NPI number — HOMECARE MEDICAL EQUIPMENT & SERVICES

Table of content: (NPI 1265415368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265415368 NPI number — HOMECARE MEDICAL EQUIPMENT & SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOMECARE MEDICAL EQUIPMENT & SERVICES
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:
H.M.E.
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:
1265415368
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2118 ROYAL FERN CT.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONGWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32779
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-689-3699
Provider Business Mailing Address Fax Number:
407-774-6948

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4333 SILVER STAR ROAD
Provider Second Line Business Practice Location Address:
SUITE 115
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32808-5169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-689-3699
Provider Business Practice Location Address Fax Number:
407-774-6948
Provider Enumeration Date:
11/22/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RODGERS
Authorized Official First Name:
LENARD
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
CEO/ PRESIDENT
Authorized Official Telephone Number:
407-522-3664

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  393 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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