Healthcare Provider Details

I. General information

NPI: 1811047913
Provider Name (Legal Business Name): IN HOME MEDICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SW 20TH ST
PENDLETON OR
97801-1806
US

IV. Provider business mailing address

9527 SANDIFUR PKWY
PASCO WA
99301-9105
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-6293
  • Fax: 541-278-3427
Mailing address:
  • Phone: 509-547-2246
  • Fax: 509-547-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. DAWN RENEE ROLPH
Title or Position: OFFICE MANAGER
Credential:
Phone: 509-547-2246