Healthcare Provider Details

I. General information

NPI: 1336135151
Provider Name (Legal Business Name): IN-HOME MEDICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9527 SANDIFUR PKWY
PASCO WA
99301-9105
US

IV. Provider business mailing address

9527 SANDIFUR PKWY
PASCO WA
99301-9105
US

V. Phone/Fax

Practice location:
  • Phone: 509-547-2246
  • Fax:
Mailing address:
  • Phone: 509-547-2246
  • Fax: 509-547-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberATP6816
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES E JEWELL
Title or Position: CEO
Credential:
Phone: 509-547-2246