Provider Demographics
NPI:1568013126
Name:HOME PHARM L.L.C
Entity Type:Organization
Organization Name:HOME PHARM L.L.C
Other - Org Name:BRIGHTSTAR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BRANCH MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASSAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-442-7815
Mailing Address - Street 1:410 N DILLARD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2853
Mailing Address - Country:US
Mailing Address - Phone:407-877-0720
Mailing Address - Fax:
Practice Address - Street 1:410 N DILLARD ST STE 102
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-2853
Practice Address - Country:US
Practice Address - Phone:407-877-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-25
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299993472OtherLICENSE