Provider Demographics
NPI:1053660100
Name:MEDICAL HOME DESIGN & RENOVATION
Entity Type:Organization
Organization Name:MEDICAL HOME DESIGN & RENOVATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AIREN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-697-9667
Mailing Address - Street 1:1181 THOMPSON CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LEONARD
Mailing Address - State:MD
Mailing Address - Zip Code:20685-2917
Mailing Address - Country:US
Mailing Address - Phone:267-697-9667
Mailing Address - Fax:
Practice Address - Street 1:1181 THOMPSON CT
Practice Address - Street 2:
Practice Address - City:SAINT LEONARD
Practice Address - State:MD
Practice Address - Zip Code:20685-2917
Practice Address - Country:US
Practice Address - Phone:267-697-9667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies