Healthcare Provider Details

I. General information

NPI: 1831360858
Provider Name (Legal Business Name): HOME CARE MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11330 LAKEFIELD DR BLD # 2 STE 200
DULUTH GA
30097-4425
US

IV. Provider business mailing address

11330 LAKEFIELD DR BLD # 2 STE 200
DULUTH GA
30097
US

V. Phone/Fax

Practice location:
  • Phone: 770-814-4113
  • Fax: 770-814-4116
Mailing address:
  • Phone: 770-814-4113
  • Fax: 770-814-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. RIMISHA M PATEL
Title or Position: CEO
Credential: RPH
Phone: 770-814-4113