Provider Demographics
NPI:1932338100
Name:HOMEFRONT DIAGNOSTICS INC
Entity Type:Organization
Organization Name:HOMEFRONT DIAGNOSTICS INC
Other - Org Name:APNEASURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:E
Authorized Official - Last Name:HALE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:386-951-6654
Mailing Address - Street 1:650 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32095-8891
Mailing Address - Country:US
Mailing Address - Phone:386-951-6654
Mailing Address - Fax:386-868-5010
Practice Address - Street 1:650 MARKET ST
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32095-8891
Practice Address - Country:US
Practice Address - Phone:386-951-6654
Practice Address - Fax:386-868-5010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4CC8494293D00000X
FLHCC8494293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory