Provider Demographics
NPI:1538249107
Name:HOME AND HOSPITAL MEDICAL SUPPLIES AND SERVICES, INC
Entity type:Organization
Organization Name:HOME AND HOSPITAL MEDICAL SUPPLIES AND SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-724-6767
Mailing Address - Street 1:44 1/2 NEW HARTFORD SHOPPING CENTER
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413
Mailing Address - Country:US
Mailing Address - Phone:315-724-6767
Mailing Address - Fax:315-724-2037
Practice Address - Street 1:44 1/2 NEW HARTFORD SHOPPING CENTER
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413
Practice Address - Country:US
Practice Address - Phone:315-724-6767
Practice Address - Fax:315-724-2037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01088788Medicaid
NY0200180001Medicare ID - Type Unspecified