Provider Demographics
NPI:1760606842
Name:THE HOME HEALTHSTORE OF TOMBALL
Entity Type:Organization
Organization Name:THE HOME HEALTHSTORE OF TOMBALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT RECEIVABLES REP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:BILLING REP
Authorized Official - Phone:330-923-5258
Mailing Address - Street 1:444 HOLDERRIETH BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4553
Mailing Address - Country:US
Mailing Address - Phone:330-923-5258
Mailing Address - Fax:330-928-2848
Practice Address - Street 1:444 HOLDERRIETH BLVD STE 6
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4553
Practice Address - Country:US
Practice Address - Phone:281-351-6216
Practice Address - Fax:281-351-7989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies