Provider Demographics
NPI:1366473050
Name:HOME THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:HOME THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:301-528-4663
Mailing Address - Street 1:906 SUMMER SWEET LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5549
Mailing Address - Country:US
Mailing Address - Phone:301-528-4663
Mailing Address - Fax:301-829-8640
Practice Address - Street 1:906 SUMMER SWEET LN
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5549
Practice Address - Country:US
Practice Address - Phone:301-528-4663
Practice Address - Fax:301-829-8640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12464485332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5723030001Medicare NSC
MDG02139Medicare ID - Type Unspecified