Provider Demographics
NPI:1790008845
Name:ABC HOME MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ABC HOME MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-897-8588
Mailing Address - Street 1:525 N TRYON ST
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-0200
Mailing Address - Country:US
Mailing Address - Phone:866-897-8588
Mailing Address - Fax:972-270-7282
Practice Address - Street 1:12630 E NORTHWEST HWY
Practice Address - Street 2:SUITE 303
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-8025
Practice Address - Country:US
Practice Address - Phone:972-279-9090
Practice Address - Fax:972-270-7282
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABC HOME MEDICAL SUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0069038332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies