Provider Demographics
NPI:1235990193
Name:HOME CARE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:HOME CARE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAITERIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-581-4200
Mailing Address - Street 1:7616 FOOTHILL BLVD UNIT 3
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2185
Mailing Address - Country:US
Mailing Address - Phone:818-581-4200
Mailing Address - Fax:818-864-0472
Practice Address - Street 1:7616 FOOTHILL BLVD UNIT 3
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2185
Practice Address - Country:US
Practice Address - Phone:818-581-4200
Practice Address - Fax:818-864-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies