Provider Demographics
NPI:1457340408
Name:HOME PRESCRIPTION SERVICES INC
Entity Type:Organization
Organization Name:HOME PRESCRIPTION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-592-5244
Mailing Address - Street 1:11134 Q ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3609
Mailing Address - Country:US
Mailing Address - Phone:402-592-5244
Mailing Address - Fax:402-592-2501
Practice Address - Street 1:11134 Q ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3609
Practice Address - Country:US
Practice Address - Phone:402-592-5244
Practice Address - Fax:402-592-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2639333600000X
IA3586333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2586OtherLICENSE NUMBER
NE2639OtherLICENSE NUMBER
NE2817039OtherNABP
NE099740OtherMEDICARE B
NE10025225700Medicaid
NE10025225700Medicaid
NE2639OtherLICENSE NUMBER