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General NPI Number Information
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NPI Number | 1285882068
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Entity Type | Organization
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Legal Business Name | HOME HEALTH SUPPLIES INC
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 2200 S MAIN ST SUITE 213
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City | LOMBARD
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State | IL
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Zip | 60148-5334
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Country | US
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Telephone | 630-424-2850
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Fax | 708-398-7610
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Provider Business Mailing Address
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Address Line | 2200 S MAIN ST SUITE 213
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City | LOMBARD
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State | IL
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Zip | 60148-5334
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Country | US
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Telephone | 630-424-2850
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Fax | 708-398-7610
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. FARAH SHAISTA
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Credential |
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Telephone | 630-660-8930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 036065312
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License Number State | IL
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