Healthcare Provider Details

I. General information

NPI: 1295446391
Provider Name (Legal Business Name): HOME AND HEALTH STORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 W CHEYENNE AVE STE 104
LAS VEGAS NV
89129-7409
US

IV. Provider business mailing address

7450 W CHEYENNE AVE STE 104
LAS VEGAS NV
89129-7409
US

V. Phone/Fax

Practice location:
  • Phone: 702-747-7227
  • Fax:
Mailing address:
  • Phone: 702-747-7227
  • Fax:

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: MR. FRANCIS TODD JONES
Title or Position: OWNER/CEO
Credential:
Phone: 702-747-7227