Provider Demographics
NPI:1821282005
Name:HOMELAND MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:HOMELAND MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING MANAGER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-483-8291
Mailing Address - Street 1:PO BOX 1265
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20718-1265
Mailing Address - Country:US
Mailing Address - Phone:202-438-8291
Mailing Address - Fax:301-464-8288
Practice Address - Street 1:13903 AMBERLY CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4811
Practice Address - Country:US
Practice Address - Phone:202-438-8291
Practice Address - Fax:301-464-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)