=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093711350
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOMECARE MEDICAL EQUIPMENT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2005
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3411 MCNIEL AVE STE 101
-----------------------------------------------------
City | WICHITA FALLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76308-1512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-691-4347
-----------------------------------------------------
Fax | 940-691-4654
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 9058
-----------------------------------------------------
City | WICHITA FALLS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76308-9058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 940-691-4347
-----------------------------------------------------
Fax | 940-691-4654
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. RON HOOVER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 940-691-4347
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0037365
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------