MEDICARE: ONE HOME MEDICAL EQUIPMENT VA, 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)

General Provider Information

NPI Number	:	1578207593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONE HOME MEDICAL EQUIPMENT VA, LLC

Provider Business Mailing Address
First Line	:	3351 EXECUTIVE WAY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3935
Country	:	US
Telephone Number	:	786-234-9095
Fax Number	:

Provider Business Practice Location Address
First Line	:	4905 CROWE DRIVE
Second Line	:
City	:	MOUNT CRAWFORD
State	:	VA
Zip	:	22841
Country	:	US
Telephone Number	:	855-441-6900
Fax Number	:	855-441-6941

Authorized Official
Title or Position	:	CFO
Name	:	RYAN COCHRAN
Credential	:
Telephone Number	:	786-234-9095

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	04/26/2022

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