Provider Demographics
NPI:1659325579
Name:COMMUNITY HME LLC
Entity Type:Organization
Organization Name:COMMUNITY HME LLC
Other - Org Name:MIDWEST RESPIRATORY CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-592-2435
Mailing Address - Street 1:9931 S 136TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68138-3937
Mailing Address - Country:US
Mailing Address - Phone:402-592-2435
Mailing Address - Fax:402-592-6914
Practice Address - Street 1:130 RICHLAND SQ
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-2947
Practice Address - Country:US
Practice Address - Phone:608-355-0774
Practice Address - Fax:608-355-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1822-45332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41701900Medicaid
WI41701900Medicaid