MEDICARE: BAR HOME MEDICAL & SCRUBS, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies	1000074	TX

General Provider Information

NPI Number	:	1528297454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAR HOME MEDICAL & SCRUBS, LLC

Provider Business Mailing Address
First Line	:	2808 S MAIN ST
Second Line	:	SUITE K
City	:	LINDALE
State	:	TX
Zip	:	75771-7774
Country	:	US
Telephone Number	:	903-881-9500
Fax Number	:	903-881-9523

Provider Business Practice Location Address
First Line	:	2808 S MAIN ST
Second Line	:	SUITE K
City	:	LINDALE
State	:	TX
Zip	:	75771-7774
Country	:	US
Telephone Number	:	903-881-9500
Fax Number	:	903-881-9523

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ROBERT DANE
Credential	:
Telephone Number	:	903-881-9500

Provider Enumeration Date	:	07/13/2009
Last Update Date	:	07/13/2009

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