MEDICARE: HOME MEDICAL RESOURCES, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1588957591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME MEDICAL RESOURCES, INC.

Provider Business Mailing Address
First Line	:	6210 CONSTITUTION DR STE F
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1588
Country	:	US
Telephone Number	:	260-432-2994
Fax Number	:	260-459-2907

Provider Business Practice Location Address
First Line	:	6210 CONSTITUTION DR STE F
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1588
Country	:	US
Telephone Number	:	260-432-2994
Fax Number	:	260-459-2907

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CHRISTI C. EVERSON
Credential	:	RN
Telephone Number	:	260-432-2294

Provider Enumeration Date	:	05/24/2011
Last Update Date	:	05/24/2011

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