Provider Demographics
NPI:1518007947
Name:HOME CARE MEDICAL SYSTEM INC
Entity Type:Organization
Organization Name:HOME CARE MEDICAL SYSTEM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:T
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:SR
Authorized Official - Credentials:CRTT
Authorized Official - Phone:870-734-4304
Mailing Address - Street 1:P.O. BOX 409
Mailing Address - Street 2:
Mailing Address - City:BRINKLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72021
Mailing Address - Country:US
Mailing Address - Phone:870-734-4304
Mailing Address - Fax:870-734-4695
Practice Address - Street 1:105 SOUTH NEW ORLEANS AVENUE
Practice Address - Street 2:
Practice Address - City:BRINKLEY
Practice Address - State:AR
Practice Address - Zip Code:72021
Practice Address - Country:US
Practice Address - Phone:870-734-4304
Practice Address - Fax:870-734-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARMG00239332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49245OtherAR BLUE CROSS
AR103566716Medicaid
0204490001Medicare UPIN