MEDICARE: AMERICAN HOME CARE SUPPLY COMPANY, INC.

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)	3000007528	PA
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	3000007528	PA
3	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

General Provider Information

NPI Number	:	1902880271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HOME CARE SUPPLY COMPANY, INC.

Provider Business Mailing Address
First Line	:	4113 BIRNEY AVE
Second Line	:
City	:	MOOSIC
State	:	PA
Zip	:	18507-1301
Country	:	US
Telephone Number	:	570-961-0155
Fax Number	:	570-961-1802

Provider Business Practice Location Address
First Line	:	38 N MAIN ST
Second Line	:
City	:	MANSFIELD
State	:	PA
Zip	:	16933-1422
Country	:	US
Telephone Number	:	570-662-7001
Fax Number	:	570-662-7229

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD L PARA
Credential	:
Telephone Number	:	570-961-0155

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	04/09/2013

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Directions to “AMERICAN HOME CARE SUPPLY COMPANY, INC. ” Practice Location

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