Provider Demographics
NPI:1043750235
Name:HOMETOWN HEALTHCARE INC.
Entity Type:Organization
Organization Name:HOMETOWN HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOMAJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-328-0074
Mailing Address - Street 1:26 CORPORATE DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-8603
Mailing Address - Country:US
Mailing Address - Phone:518-500-0000
Mailing Address - Fax:518-271-9973
Practice Address - Street 1:26 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-8603
Practice Address - Country:US
Practice Address - Phone:518-500-0000
Practice Address - Fax:518-271-9973
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMETOWN HEALTHCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-07
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00522647Medicaid
0437080007Medicare PIN
NY00522647Medicaid