Provider Demographics
NPI:1114081270
Name:MED 4 HOME INC.
Entity Type:Organization
Organization Name:MED 4 HOME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-530-7700
Mailing Address - Street 1:19387 US HIGHWAY 19 N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3102
Mailing Address - Country:US
Mailing Address - Phone:800-284-2006
Mailing Address - Fax:
Practice Address - Street 1:10800 N CONGRESS AVE
Practice Address - Street 2:STE A
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1228
Practice Address - Country:US
Practice Address - Phone:816-801-7400
Practice Address - Fax:816-801-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA548941Medicaid
AR145877716Medicaid
TN4582249Medicaid
MO626167803Medicaid
KY90004698Medicaid
TN4582249Medicaid
IA548941Medicaid
MO4290280001Medicare NSC