Provider Demographics
NPI:1255484994
Name:HOMECARE MEDICAL PRODUCTS INC
Entity Type:Organization
Organization Name:HOMECARE MEDICAL PRODUCTS INC
Other - Org Name:COMFORTCARE MEDICAL PRODUCTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
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 1:15823 MONTE ST STE E106
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-7675
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:2007-01-18
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4496250002Medicare ID - Type UnspecifiedMEDICARE PROVIDER #