Provider Demographics
NPI:1083086185
Name:HOMA DME PC
Entity Type:Organization
Organization Name:HOMA DME PC
Other - Org Name:COMPLETE INJURY CARE DIRECTENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-622-0809
Mailing Address - Street 1:200 E ARCH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-2982
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 E ARCH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-2982
Practice Address - Country:US
Practice Address - Phone:570-622-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies