=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659736304
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME CARE MEDICAL SYSTEMS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2015
-----------------------------------------------------
Last Update Date | 04/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2565 HORIZON LAKE DR STE 113
-----------------------------------------------------
City | MEMPHIS
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38133-8113
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-831-1159
-----------------------------------------------------
Fax | 855-232-7017
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 260 W MAIN ST SUITE 217
-----------------------------------------------------
City | HENDERSONVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37075-3347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-831-1159
-----------------------------------------------------
Fax | 877-741-8964
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | FRANK MOORE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 800-831-1159
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number | 0000004372
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------