Provider Demographics
NPI:1871633479
Name:HOMECARE MEDICAL PRODUCTS INC
Entity Type:Organization
Organization Name:HOMECARE MEDICAL PRODUCTS INC
Other - Org Name:COMFORTCARE HEARING AID CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVOUKJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-666-0414
Mailing Address - Street 1:478 W COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1504
Mailing Address - Country:US
Mailing Address - Phone:818-247-7000
Mailing Address - Fax:818-247-1323
Practice Address - Street 1:478 W COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1504
Practice Address - Country:US
Practice Address - Phone:818-247-7000
Practice Address - Fax:818-247-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3314332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0033140Medicaid