1902930803 NPI number — HOMECARE MEDICAL EQUIPMENT, INC.

Table of content: (NPI 1902930803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902930803 NPI number — HOMECARE MEDICAL EQUIPMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOMECARE MEDICAL EQUIPMENT, INC.
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:
Provider Other Organization Name Type Code:
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:
1902930803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36518 FRANCINE CIRCLE SOUTH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GEISMAR
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70734
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-369-3333
Provider Business Mailing Address Fax Number:
985-369-3334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6085 HIGHWAY ONE SUITE-C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PAINCOURTVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70391
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-369-3333
Provider Business Practice Location Address Fax Number:
985-369-3334
Provider Enumeration Date:
03/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BROWN
Authorized Official First Name:
TROY
Authorized Official Middle Name:
E.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
985-369-3333

Provider Taxonomy Codes

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

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

  • Identifier: 1434337 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".