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General NPI Number Information
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NPI Number | 1508025586
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Entity Type | Organization
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Legal Business Name | HOMESTAR MED EQUIP & INF SVS
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 1200 WELSH RD STORE M
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City | NORTH WALES
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State | PA
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Zip | 19454-3771
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Country | US
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Telephone | 215-361-9794
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Fax |
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Provider Business Mailing Address
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Address Line | 77 S COMMERCE WAY
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City | BETHLEHEM
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State | PA
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Zip | 18017-8917
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Country | US
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Telephone | 610-419-7600
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Fax | 610-882-9105
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DOMINICK DESARRO
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Credential |
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Telephone | 610-419-7610
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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 | 1000002573
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 1000002573
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 1000002573
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License Number State | PA
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