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General NPI Number Information
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NPI Number | 1114920410
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Entity Type | Organization
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Legal Business Name | HOME AGAIN OXYGEN AND MOBILITY PRODUCTS
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 25270 BERNWOOD DR UNIT 5
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7897
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Country | US
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Telephone | 239-390-1077
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Fax | 239-390-0444
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Provider Business Mailing Address
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Address Line | 25270 BERNWOOD DR UNIT 5
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-7897
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Country | US
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Telephone | 239-390-1077
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Fax | 239-390-0444
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICHARD G HEADLEY
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Credential |
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Telephone | 239-390-1077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1651
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License Number State | FL
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