Provider Demographics
NPI:1932367075
Name:FAMILY HOME MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:FAMILY HOME MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-235-4683
Mailing Address - Street 1:518 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHREWSBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17361-1739
Mailing Address - Country:US
Mailing Address - Phone:717-235-4683
Mailing Address - Fax:
Practice Address - Street 1:518 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-1739
Practice Address - Country:US
Practice Address - Phone:717-235-4683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HOME MEDICAL SUPPLY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-27
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA82539053332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50020429OtherCAPITAL BLUE CROSS
PA001493151OtherHIGHMARK BLUE SHIELD
PA641164120OtherTRICARE MSC
PA20035207OtherAMERIHEALTH
PA641164120OtherTRICARE MSC