Provider Demographics
NPI:1255471744
Name:HOMECARE MEDICAL PRODUCTS INC
Entity Type:Organization
Organization Name:HOMECARE MEDICAL PRODUCTS INC
Other - Org Name:COMFORTCARE HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:HAIKOUHI
Authorized Official - Middle Name:HEIDI
Authorized Official - Last Name:KAVOUKJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-666-0414
Mailing Address - Street 1:5220 SANTA MONICA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1234
Mailing Address - Country:US
Mailing Address - Phone:323-666-0414
Mailing Address - Fax:323-913-4138
Practice Address - Street 1:15823 MONTE ST STE E106
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-7675
Practice Address - Country:US
Practice Address - Phone:323-666-0414
Practice Address - Fax:323-913-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2983332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0029830Medicaid