Provider Demographics
NPI:1790987907
Name:AT HOME MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:AT HOME MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOCELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-871-8841
Mailing Address - Street 1:219 MOUNT LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-9557
Mailing Address - Country:US
Mailing Address - Phone:888-871-8841
Mailing Address - Fax:888-871-8847
Practice Address - Street 1:219 MOUNT LAUREL RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-9557
Practice Address - Country:US
Practice Address - Phone:888-871-8841
Practice Address - Fax:888-871-8847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5946980001Medicare NSC