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General NPI Number Information
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NPI Number | 1194817379
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Entity Type | Organization
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Legal Business Name | HOME MEDISERVICE LLC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 4690 MILLENNIUM DR STE 323
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City | BELCAMP
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State | MD
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Zip | 21017-1523
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Country | US
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Telephone | 410-939-1212
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Fax | 410-939-5952
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Provider Business Mailing Address
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Address Line | 220 W GERMANTOWN PIKE STE 250
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City | PLYMOUTH MEETING
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State | PA
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Zip | 19462-1437
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Country | US
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Telephone | 610-424-4515
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | WENDY RUSSALESI
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Credential |
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Telephone | 484-246-9499
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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 |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | MD
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