Provider Demographics
NPI:1760065700
Name:HOME MEDICAL SELF CARE INC
Entity Type:Organization
Organization Name:HOME MEDICAL SELF CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-333-4782
Mailing Address - Street 1:1919 NE 45TH ST STE 222
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5136
Mailing Address - Country:US
Mailing Address - Phone:754-333-4782
Mailing Address - Fax:
Practice Address - Street 1:1919 NE 45TH ST STE 222
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5136
Practice Address - Country:US
Practice Address - Phone:754-333-4782
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies