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NPI Code Detail

MEDICARE: THETA HOME HEALTH CARE INC

MEDICARE: THETA HOME HEALTH CARE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332BC3200XCustomized Equipment (DME)
2332BP3500XParenteral & Enteral Nutrition Supplies (DME)
3332BX2000XOxygen Equipment & Supplies (DME)
4335E00000XProsthetic/Orthotic Supplier
5332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275594202
Entity Type Code : Organization
Provider Name (Legal Business Name) : THETA HOME HEALTH CARE INC
Provider Business Mailing Address
First Line : PO BOX 27968
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0968
Country : US
Telephone Number : 407-246-1226
Fax Number : 407-648-2297
Provider Business Practice Location Address
First Line : 1986 AIRPORT BLVD
Second Line :
City : ALEXANDER CITY
State : AL
Zip : 35010-3354
Country : US
Telephone Number : 256-234-0873
Fax Number : 256-329-0517
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MRS. ROBIN L MENCHEN
Credential :
Telephone Number : 407-822-4600
Provider Enumeration Date : 03/29/2006
Last Update Date : 04/15/2024

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Directions to “THETA HOME HEALTH CARE INC ” Practice Location

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