Provider Demographics
NPI:1578655445
Name:HOMER INC
Entity Type:Organization
Organization Name:HOMER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAJANDAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-852-5155
Mailing Address - Street 1:18 CALLE FONT MARTELO
Mailing Address - Street 2:PO BOX 8782
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-3342
Mailing Address - Country:US
Mailing Address - Phone:787-852-5155
Mailing Address - Fax:787-850-7403
Practice Address - Street 1:18 CALLE FONT MARTELO
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3342
Practice Address - Country:US
Practice Address - Phone:787-852-5155
Practice Address - Fax:787-850-7403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0408530001Medicare ID - Type UnspecifiedSUPPLIER'S NUMBER