Provider Demographics
NPI:1073885422
Name:HOMEMED DIAGNOSTIC SOLUTIONS, LLC
Entity Type:Organization
Organization Name:HOMEMED DIAGNOSTIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ILIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-709-1131
Mailing Address - Street 1:328 S SAGE AVE STE 307C
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-3629
Mailing Address - Country:US
Mailing Address - Phone:251-709-1131
Mailing Address - Fax:251-650-1681
Practice Address - Street 1:328 S SAGE AVE STE 307C
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3629
Practice Address - Country:US
Practice Address - Phone:251-709-1131
Practice Address - Fax:251-650-1681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment