Provider Demographics
NPI:1720019755
Name:IN THE HOUSE MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:IN THE HOUSE MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DURABLE MEDICAL EQUIPMENT PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:AUBREY
Authorized Official - Last Name:POPE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-834-0318
Mailing Address - Street 1:12 WENDY CT STE M
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2249
Mailing Address - Country:US
Mailing Address - Phone:336-834-0318
Mailing Address - Fax:866-435-0003
Practice Address - Street 1:12 WENDY CT STE M
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2249
Practice Address - Country:US
Practice Address - Phone:336-834-0318
Practice Address - Fax:866-435-0003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC00970332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7704259Medicaid
NC7704259Medicaid