Provider Demographics
NPI:1417392861
Name:HOMECARE DME
Entity Type:Organization
Organization Name:HOMECARE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-817-1930
Mailing Address - Street 1:PO BOX 1987
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29465-1987
Mailing Address - Country:US
Mailing Address - Phone:843-817-1930
Mailing Address - Fax:
Practice Address - Street 1:2353 HIGHWAY 17 BYP N
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-6807
Practice Address - Country:US
Practice Address - Phone:843-817-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3486Medicaid