Provider Demographics
NPI:1346294501
Name:TRI COUNTY HOME MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:TRI COUNTY HOME MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-507-2561
Mailing Address - Street 1:PO BOX 2597
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38088-2597
Mailing Address - Country:US
Mailing Address - Phone:901-507-2561
Mailing Address - Fax:901-507-2569
Practice Address - Street 1:2222 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2405
Practice Address - Country:US
Practice Address - Phone:334-288-1003
Practice Address - Fax:334-288-1220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009903525Medicaid
AL3883230002Medicare ID - Type UnspecifiedPRATTVILLE