MEDICARE: HOME PRESCRIPTION SERVICES INC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	3586	IA
2	333600000X	Pharmacy	2639	NE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	099740	OTHER	NE	MEDICARE B

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2586	OTHER	IA	LICENSE NUMBER
2	2639	OTHER	NE	LICENSE NUMBER
3	2817039	OTHER	NE	NABP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1457340408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME PRESCRIPTION SERVICES INC

Provider Business Mailing Address
First Line	:	11134 Q ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3609
Country	:	US
Telephone Number	:	402-592-5244
Fax Number	:	402-592-2501

Provider Business Practice Location Address
First Line	:	11134 Q ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3609
Country	:	US
Telephone Number	:	402-592-5244
Fax Number	:	402-592-2501

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. TIMOTHY S DECKER
Credential	:
Telephone Number	:	402-592-5244

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	03/07/2023

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398

11134 Q ST
OMAHA, NE
68137-3609