Provider Demographics
NPI:1134110968
Name:LOBO HOME HEALTH INC.
Entity Type:Organization
Organization Name:LOBO HOME HEALTH INC.
Other - Org Name:TRANSCEND MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-259-3123
Mailing Address - Street 1:PO BOX 366
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-0366
Mailing Address - Country:US
Mailing Address - Phone:256-582-1982
Mailing Address - Fax:256-571-9158
Practice Address - Street 1:2001 HENRY ST
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976
Practice Address - Country:US
Practice Address - Phone:256-582-1982
Practice Address - Fax:256-571-9158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOBO HOME HEALTH INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-11-01
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL120332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000054007Medicaid
AL51054007OtherBS/BC ALABAMA
AL51054007OtherBS/BC ALABAMA
AL0147190002Medicare NSC