Healthcare Provider Details

I. General information

NPI: 1285541821
Provider Name (Legal Business Name): HOME CARE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 N JANTZEN AVE
PORTLAND OR
97217-7808
US

IV. Provider business mailing address

PO BOX 10463
PORTLAND OR
97296-0463
US

V. Phone/Fax

Practice location:
  • Phone: 503-869-6333
  • Fax:
Mailing address:
  • Phone: 503-869-6333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MATT GREER
Title or Position: CEO
Credential: CAPS I, II, III
Phone: 503-869-6333