Provider Demographics
NPI:1710277793
Name:HOME TESTING MANAGEMENT
Entity Type:Organization
Organization Name:HOME TESTING MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:KNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:ANP-BC
Authorized Official - Phone:337-277-9913
Mailing Address - Street 1:155 W HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-3215
Mailing Address - Country:US
Mailing Address - Phone:855-881-6086
Mailing Address - Fax:
Practice Address - Street 1:155 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-3215
Practice Address - Country:US
Practice Address - Phone:855-881-6086
Practice Address - Fax:855-881-6087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory