Provider Demographics
NPI:1114079407
Name:HOME MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:HOME MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-705-1990
Mailing Address - Street 1:4209 LAKELAND DR
Mailing Address - Street 2:SUITE 294
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9212
Mailing Address - Country:US
Mailing Address - Phone:866-425-8900
Mailing Address - Fax:866-428-8900
Practice Address - Street 1:2260 S XANADU WAY
Practice Address - Street 2:SUITE 335
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1373
Practice Address - Country:US
Practice Address - Phone:303-705-1990
Practice Address - Fax:866-428-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00183014Medicaid
MS00183014Medicaid