Provider Demographics
NPI:1629183629
Name:HOMETOWN MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:HOMETOWN MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDERICO
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:817-556-2882
Mailing Address - Street 1:2100 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7440
Mailing Address - Country:US
Mailing Address - Phone:817-556-2882
Mailing Address - Fax:817-641-3500
Practice Address - Street 1:2100 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7440
Practice Address - Country:US
Practice Address - Phone:817-556-2882
Practice Address - Fax:817-641-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016452701Medicaid
TX016452701Medicaid
TX1186310001Medicare ID - Type Unspecified