Provider Demographics
NPI:1538439021
Name:THRIFTY HOME MEDICAL
Entity type:Organization
Organization Name:THRIFTY HOME MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-667-0940
Mailing Address - Street 1:116 WALLACE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:42450-1278
Mailing Address - Country:US
Mailing Address - Phone:270-667-0940
Mailing Address - Fax:270-667-0941
Practice Address - Street 1:116 WALLACE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:KY
Practice Address - Zip Code:42450-1278
Practice Address - Country:US
Practice Address - Phone:270-667-0940
Practice Address - Fax:270-667-0941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6700430003Medicare NSC