Healthcare Provider Details

I. General information

NPI: 1215933791
Provider Name (Legal Business Name): HOME MEDICAL EQUIPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 LUMBER RD
ROSLYN NY
11576-2105
US

IV. Provider business mailing address

5959 SHALLOWFORD RD STE 443
CHATTANOOGA TN
37421-2245
US

V. Phone/Fax

Practice location:
  • Phone: 516-505-1200
  • Fax: 516-505-1211
Mailing address:
  • Phone: 423-756-2268
  • Fax: 423-266-9690

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number02386423
License Number StateNY

VIII. Authorized Official

Name: JEFFREY MATUKEWICZ
Title or Position: SECRETARY
Credential:
Phone: 423-756-2268