Provider Demographics
NPI:1124207782
Name:HOME CARE MEDICAL LLC
Entity Type:Organization
Organization Name:HOME CARE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-483-9414
Mailing Address - Street 1:53 EAST INDUSTRIAL ROAD
Mailing Address - Street 2:SUITE B2
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405
Mailing Address - Country:US
Mailing Address - Phone:203-483-9414
Mailing Address - Fax:203-483-9354
Practice Address - Street 1:53 EAST INDUSTRIAL ROAD
Practice Address - Street 2:SUITE B2
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405
Practice Address - Country:US
Practice Address - Phone:203-483-9414
Practice Address - Fax:203-483-9354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004192100Medicaid
CT004192100Medicaid