MEDICARE: MEDICAL HOME DESIGN & RENOVATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1053660100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL HOME DESIGN & RENOVATION

Provider Business Mailing Address
First Line	:	1181 THOMPSON CT
Second Line	:
City	:	SAINT LEONARD
State	:	MD
Zip	:	20685-2917
Country	:	US
Telephone Number	:	267-697-9667
Fax Number	:

Provider Business Practice Location Address
First Line	:	1181 THOMPSON CT
Second Line	:
City	:	SAINT LEONARD
State	:	MD
Zip	:	20685-2917
Country	:	US
Telephone Number	:	267-697-9667
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. AIREN R HESS
Credential	:
Telephone Number	:	267-697-9667

Provider Enumeration Date	:	09/05/2012
Last Update Date	:	09/05/2012

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