Healthcare Provider Details

I. General information

NPI: 1902880271
Provider Name (Legal Business Name): AMERICAN HOME CARE SUPPLY COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 N MAIN ST
MANSFIELD PA
16933-1422
US

IV. Provider business mailing address

4113 BIRNEY AVE
MOOSIC PA
18507-1301
US

V. Phone/Fax

Practice location:
  • Phone: 570-662-7001
  • Fax: 570-662-7229
Mailing address:
  • Phone: 570-961-0155
  • Fax: 570-961-1802

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number3000007528
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number3000007528
License Number StatePA

VIII. Authorized Official

Name: MR. RICHARD L PARA
Title or Position: PRESIDENT
Credential:
Phone: 570-961-0155