MEDICARE: HOME AND HEALTH STORE

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	332BX2000X	Oxygen Equipment & Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1295446391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME AND HEALTH STORE

Provider Business Mailing Address
First Line	:	7450 W CHEYENNE AVE STE 104
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7409
Country	:	US
Telephone Number	:	702-747-7227
Fax Number	:

Provider Business Practice Location Address
First Line	:	7450 W CHEYENNE AVE STE 104
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7409
Country	:	US
Telephone Number	:	702-747-7227
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MR. FRANCIS TODD JONES
Credential	:
Telephone Number	:	702-747-7227

Provider Enumeration Date	:	12/08/2022
Last Update Date	:	12/08/2022

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Directions to “HOME AND HEALTH STORE ” Practice Location

Language	Start Address	Practice Location

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