MEDICARE: FAMILY HOME MEDICAL EQUIPMENT AND SUPPLIES

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821051707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HOME MEDICAL EQUIPMENT AND SUPPLIES

Provider Business Mailing Address
First Line	:	7816 PARSTON DR
Second Line	:
City	:	FORESTVILLE
State	:	MD
Zip	:	20747-4424
Country	:	US
Telephone Number	:	301-735-6020
Fax Number	:	301-735-6021

Provider Business Practice Location Address
First Line	:	7816 PARSTON DR
Second Line	:
City	:	FORESTVILLE
State	:	MD
Zip	:	20747-4424
Country	:	US
Telephone Number	:	301-735-6020
Fax Number	:	301-735-6021

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. TINA LOUISE JACKSON-WHITE
Credential	:
Telephone Number	:	301-735-6020

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	11/19/2008

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Directions to “FAMILY HOME MEDICAL EQUIPMENT AND SUPPLIES ” Practice Location

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