MEDICARE: HOME FURNITURE & APPLIANCE 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
1	332BC3200X	Customized Equipment (DME)	032086206	SC

General Provider Information

NPI Number	:	1275769572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME FURNITURE & APPLIANCE INC

Provider Business Mailing Address
First Line	:	PO BOX 66
Second Line	:
City	:	IRMO
State	:	SC
Zip	:	29063-0066
Country	:	US
Telephone Number	:	803-781-2925
Fax Number	:	803-749-1229

Provider Business Practice Location Address
First Line	:	1201 LAKE MURRAY BLVD
Second Line	:
City	:	IRMO
State	:	SC
Zip	:	29063-2826
Country	:	US
Telephone Number	:	803-781-2925
Fax Number	:	803-749-1229

Authorized Official
Title or Position	:	OWNER/PRES
Name	:	MR. GREG SHEALY
Credential	:
Telephone Number	:	803-781-2925

Provider Enumeration Date	:	06/02/2009
Last Update Date	:	06/02/2009

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