MEDICARE: HOME AGAIN MEDICAL, LLC

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	332BX2000X	Oxygen Equipment & Supplies (DME)	20-162328	AZ
2	332B00000X	Durable Medical Equipment & Medical Supplies	20-162328	AZ

General Provider Information

NPI Number	:	1225179914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME AGAIN MEDICAL, LLC

Provider Business Mailing Address
First Line	:	5016 W CACTUS RD
Second Line	:	STE 3
City	:	PHOENIX
State	:	AZ
Zip	:	85304-2245
Country	:	US
Telephone Number	:	602-272-0707
Fax Number	:	602-424-0201

Provider Business Practice Location Address
First Line	:	5016 W CACTUS RD SUITE 3
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85304-2245
Country	:	US
Telephone Number	:	602-272-0707
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JANET L CROWL
Credential	:
Telephone Number	:	602-228-3023

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	10/01/2008

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