Provider Demographics
NPI:1902030505
Name:UNIVERSALHOMEHEALTHCARESUPPLIES INC
Entity Type:Organization
Organization Name:UNIVERSALHOMEHEALTHCARESUPPLIES INC
Other - Org Name:HEALTH CARE SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LONZO
Authorized Official - Middle Name:O-KEEFE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-307-8879
Mailing Address - Street 1:3907 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-3323
Mailing Address - Country:US
Mailing Address - Phone:804-307-5650
Mailing Address - Fax:
Practice Address - Street 1:3907 DECATUR ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-3323
Practice Address - Country:US
Practice Address - Phone:804-307-5650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies