Provider Demographics
NPI:1952481509
Name:MEDICAL HOME CARE INC.
Entity Type:Organization
Organization Name:MEDICAL HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-792-6872
Mailing Address - Street 1:32 STONY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1167
Mailing Address - Country:US
Mailing Address - Phone:203-792-6872
Mailing Address - Fax:203-798-8640
Practice Address - Street 1:32 STONY HILL RD
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1167
Practice Address - Country:US
Practice Address - Phone:203-792-6872
Practice Address - Fax:203-798-8640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004021002Medicaid
NY00695198Medicaid
NY00695198Medicaid