Provider Demographics
NPI:1437119690
Name:HOME MEDICAL, INC
Entity Type:Organization
Organization Name:HOME MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:CONGER
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, MSW
Authorized Official - Phone:803-649-1726
Mailing Address - Street 1:309 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-0005
Mailing Address - Country:US
Mailing Address - Phone:803-649-1726
Mailing Address - Fax:803-641-7917
Practice Address - Street 1:309 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-0005
Practice Address - Country:US
Practice Address - Phone:803-649-1726
Practice Address - Fax:803-641-7917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC50002992333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC729924Medicaid
SC729924Medicaid
SC729924Medicaid