Provider Demographics
NPI:1770635609
Name:HOME CARE MEDICAL, INC
Entity Type:Organization
Organization Name:HOME CARE MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEEVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-786-9870
Mailing Address - Street 1:5665 S WESTRIDGE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-7954
Mailing Address - Country:US
Mailing Address - Phone:262-786-9870
Mailing Address - Fax:262-786-9878
Practice Address - Street 1:2604 S 162ND ST
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-2810
Practice Address - Country:US
Practice Address - Phone:262-786-9870
Practice Address - Fax:262-901-0447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI220146332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies