Provider Demographics
NPI:1497835243
Name:FAMILY HOME MEDICAL EQPT & SUPPLIES INC
Entity type:Organization
Organization Name:FAMILY HOME MEDICAL EQPT & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRES
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MANGUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-820-1449
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:WEAVER
Mailing Address - State:AL
Mailing Address - Zip Code:36277
Mailing Address - Country:US
Mailing Address - Phone:256-820-1449
Mailing Address - Fax:256-820-1425
Practice Address - Street 1:6512 MCCLELLAN BLVD
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36206
Practice Address - Country:US
Practice Address - Phone:256-820-1449
Practice Address - Fax:256-820-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51057988OtherBCBS OF AL
AL51057988OtherBCBS OF AL