Provider Demographics
NPI:1649418625
Name:HOME MEDICAL RENTAL, INC.
Entity Type:Organization
Organization Name:HOME MEDICAL RENTAL, INC.
Other - Org Name:HOME MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-226-4663
Mailing Address - Street 1:1204 SHREVEPORT BARKSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2406
Mailing Address - Country:US
Mailing Address - Phone:318-226-4663
Mailing Address - Fax:318-222-6019
Practice Address - Street 1:1204 SHREVEPORT BARKSDALE HWY
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2406
Practice Address - Country:US
Practice Address - Phone:318-226-4663
Practice Address - Fax:318-222-6019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1320307Medicaid
LA1320307Medicaid