Provider Demographics
NPI:1376639427
Name:SIERRA HOME MEDICAL LLC
Entity Type:Organization
Organization Name:SIERRA HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER MEMBER SIERRA HOME MEDICAL
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-268-4568
Mailing Address - Street 1:1830 W CALDWELL
Mailing Address - Street 2:STE E
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277
Mailing Address - Country:US
Mailing Address - Phone:559-268-4568
Mailing Address - Fax:559-268-4569
Practice Address - Street 1:1830 W CALDWELL
Practice Address - Street 2:STE E
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:559-627-4456
Practice Address - Fax:559-627-4479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME00287FMedicaid
4693310001Medicare ID - Type Unspecified