Provider Demographics
NPI:1245252352
Name:FAMILY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:FAMILY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-942-4807
Mailing Address - Street 1:104 N 14TH ST.
Mailing Address - Street 2:P O BOX 668
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948
Mailing Address - Country:US
Mailing Address - Phone:618-942-4807
Mailing Address - Fax:618-942-2751
Practice Address - Street 1:104 N 14TH ST
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3130
Practice Address - Country:US
Practice Address - Phone:618-942-4807
Practice Address - Fax:618-942-2751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL0167750001Medicare ID - Type UnspecifiedPROVIDER NUMBER