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General NPI Number Information
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NPI Number | 1275767584
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Entity Type | Organization
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Legal Business Name | HOMEWELL MEDICAL INC
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 360 N MOUNT ZION RD SUITE D
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City | LEBANON
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State | IN
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Zip | 46052-8330
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Country | US
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Telephone | 317-605-9327
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Fax | 866-906-1187
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Provider Business Mailing Address
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Address Line | 360 N MOUNT ZION RD SUITE D
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City | LEBANON
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State | IN
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Zip | 46052-8330
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Country | US
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Telephone | 317-605-9327
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Fax | 866-906-1187
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL TYSON POE
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Credential |
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Telephone | 317-605-9327
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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 | 69000592A
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License Number State | IN
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