Provider Demographics
NPI:1255197273
Name:HOME-BOUND-MED LLC
Entity type:Organization
Organization Name:HOME-BOUND-MED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-799-1782
Mailing Address - Street 1:6090 SURETY DR STE 420
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2057
Mailing Address - Country:US
Mailing Address - Phone:915-303-9215
Mailing Address - Fax:915-218-6518
Practice Address - Street 1:1701 BASSETT AVE STE 115
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1801
Practice Address - Country:US
Practice Address - Phone:915-799-1782
Practice Address - Fax:915-205-6909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty