Provider Demographics
NPI:1295894632
Name:HOME MED PLUS, INC.
Entity type:Organization
Organization Name:HOME MED PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOUMEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-307-0050
Mailing Address - Street 1:PO BOX 3092
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83816
Mailing Address - Country:US
Mailing Address - Phone:208-667-1269
Mailing Address - Fax:800-859-8835
Practice Address - Street 1:5113 PACIFIC HWY E
Practice Address - Street 2:STE. 8
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-2659
Practice Address - Country:US
Practice Address - Phone:253-926-0198
Practice Address - Fax:800-859-8835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID00069542-S332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9050857Medicaid
WA9050857Medicaid