Healthcare Provider Details

I. General information

NPI: 1225179914
Provider Name (Legal Business Name): HOME AGAIN MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5016 W CACTUS RD SUITE 3
PHOENIX AZ
85304-2245
US

IV. Provider business mailing address

5016 W CACTUS RD STE 3
PHOENIX AZ
85304-2245
US

V. Phone/Fax

Practice location:
  • Phone: 602-272-0707
  • Fax:
Mailing address:
  • Phone: 602-272-0707
  • Fax: 602-424-0201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number20-162328
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number20-162328
License Number StateAZ

VIII. Authorized Official

Name: MRS. JANET L CROWL
Title or Position: PRESIDENT
Credential:
Phone: 602-228-3023