Provider Demographics
NPI:1245569649
Name:TOTAL ONE HOME MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:TOTAL ONE HOME MEDICAL EQUIPMENT INC
Other - Org Name:TOTAL HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTAZAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-822-3595
Mailing Address - Street 1:8827 TRADEWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6114
Mailing Address - Country:US
Mailing Address - Phone:210-822-3595
Mailing Address - Fax:210-822-3597
Practice Address - Street 1:8827 TRADEWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6114
Practice Address - Country:US
Practice Address - Phone:210-822-3595
Practice Address - Fax:210-822-3597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTO BE ANNOUNCED332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6422880001Medicare NSC