Healthcare Provider Details

I. General information

NPI: 1578201166
Provider Name (Legal Business Name): HOME BASED TEAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2022
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 EXECUTIVE DR
LEXINGTON KY
40505-4809
US

IV. Provider business mailing address

2257 EXECUTIVE DR STE 6
LEXINGTON KY
40505-4809
US

V. Phone/Fax

Practice location:
  • Phone: 859-346-4283
  • Fax: 949-695-3662
Mailing address:
  • Phone: 859-346-4283
  • Fax: 502-365-3955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER JONES
Title or Position: CEO/PRESIDENT
Credential:
Phone: 502-999-2271