Provider Demographics
NPI:1932109345
Name:HOME HEALTH PAVILION INC
Entity Type:Organization
Organization Name:HOME HEALTH PAVILION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ASRAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-569-1250
Mailing Address - Street 1:5027 ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1946
Mailing Address - Country:US
Mailing Address - Phone:845-569-1250
Mailing Address - Fax:
Practice Address - Street 1:5027 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-1946
Practice Address - Country:US
Practice Address - Phone:845-569-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01252060Medicaid
NY01252060Medicaid