Provider Demographics
NPI:1831360858
Name:HOME CARE MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:HOME CARE MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RIMISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:770-814-4113
Mailing Address - Street 1:11330 LAKEFIELD DR
Mailing Address - Street 2:BLD # 2 STE 200
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:770-814-4113
Mailing Address - Fax:770-814-4116
Practice Address - Street 1:11330 LAKEFIELD DR
Practice Address - Street 2:BLD # 2 STE 200
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4425
Practice Address - Country:US
Practice Address - Phone:770-814-4113
Practice Address - Fax:770-814-4116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5801130001Medicare NSC