1932163656 NPI number — HOME CARE MEDICAL SYSTEMS, INC

Table of content: (NPI 1932163656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932163656 NPI number — HOME CARE MEDICAL SYSTEMS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME CARE MEDICAL SYSTEMS, 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:
6
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:
1932163656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 2417
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSONVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37077-2417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-824-3911
Provider Business Mailing Address Fax Number:
615-826-6273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
260 WEST MAIN STREET
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37075-3347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-824-3911
Provider Business Practice Location Address Fax Number:
615-826-6273
Provider Enumeration Date:
04/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT OF CORPORATION
Authorized Official Telephone Number:
615-824-3911

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  0000001873 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , with the licence number: 0000001873 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000001873 . This is a "PHARMACY" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 9449398 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3502030 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4424040 . This is a "NCPDP" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 3555686 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54010400 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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