Provider Demographics
NPI:1710084918
Name:AMERICAN HOMECARE SUPPLY MID ATLANTIC LLC
Entity Type:Organization
Organization Name:AMERICAN HOMECARE SUPPLY MID ATLANTIC LLC
Other - Org Name:YOUNG'S MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-631-3031
Mailing Address - Street 1:2710 EMRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-8012
Mailing Address - Country:US
Mailing Address - Phone:610-882-8880
Mailing Address - Fax:610-867-7023
Practice Address - Street 1:180 LEADERS HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4742
Practice Address - Country:US
Practice Address - Phone:717-699-5511
Practice Address - Fax:717-741-4752
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANDAUER METROPOLITAN, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-20
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007735180028Medicaid
PA1281160010Medicare ID - Type Unspecified