Provider Demographics
NPI:1902963556
Name:HOME MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:319-378-6414
Mailing Address - Street 1:4726 RIVERSIDE CT NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52411-7439
Mailing Address - Country:US
Mailing Address - Phone:319-294-2400
Mailing Address - Fax:319-378-3313
Practice Address - Street 1:4726 RIVERSIDE CT NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52411-7439
Practice Address - Country:US
Practice Address - Phone:319-294-2400
Practice Address - Fax:319-378-3313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA27256OtherBCBS PROVIDER NUMBER
IA0272567Medicaid