Provider Demographics
NPI:1730248402
Name:TOM & JERRY'S HOME MEDICAL SERVICE
Entity type:Organization
Organization Name:TOM & JERRY'S HOME MEDICAL SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-628-8913
Mailing Address - Street 1:145 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-2405
Mailing Address - Country:US
Mailing Address - Phone:724-628-8913
Mailing Address - Fax:724-628-0675
Practice Address - Street 1:310 N 3RD ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1614
Practice Address - Country:US
Practice Address - Phone:724-925-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA332BP3500X332BP3500X
PA332BX2000X332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0260300002Medicare ID - Type UnspecifiedPROVIDER NUMBER