Provider Demographics
NPI:1144368929
Name:HOMELIFE MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:HOMELIFE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOURANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-357-2325
Mailing Address - Street 1:PO BOX 1605
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3550 LAWRENCEVILLE SUWANEE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7049
Practice Address - Country:US
Practice Address - Phone:678-357-2325
Practice Address - Fax:800-918-6020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4447070001Medicare ID - Type Unspecified