Provider Demographics
NPI:1487670535
Name:AMERICAN HOMECARE SUPPLY NEW YORK
Entity Type:Organization
Organization Name:AMERICAN HOMECARE SUPPLY NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-631-3031
Mailing Address - Street 1:1 BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1260
Mailing Address - Country:US
Mailing Address - Phone:800-631-3031
Mailing Address - Fax:914-840-1360
Practice Address - Street 1:138 MAIN ST
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1526
Practice Address - Country:US
Practice Address - Phone:607-324-2585
Practice Address - Fax:607-324-2588
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANDAUER METROPLITAN, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-14
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02394567Medicaid
NY02394567Medicaid