Provider Demographics
NPI:1982174116
Name:FAMILY HOME MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:FAMILY HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:
Authorized Official - Credentials:C PED, CMF
Authorized Official - Phone:812-582-0656
Mailing Address - Street 1:397 S US HIGHWAY 231
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3299
Mailing Address - Country:US
Mailing Address - Phone:812-482-6922
Mailing Address - Fax:812-482-6923
Practice Address - Street 1:397 S US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3299
Practice Address - Country:US
Practice Address - Phone:812-482-6922
Practice Address - Fax:812-482-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies