Provider Demographics
NPI:1730453515
Name:HOME CARE MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:HOME CARE MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:VAN BAUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-801-0831
Mailing Address - Street 1:16116 SW 138TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1939
Mailing Address - Country:US
Mailing Address - Phone:305-801-0831
Mailing Address - Fax:305-823-2428
Practice Address - Street 1:16116 SW 138TH PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1939
Practice Address - Country:US
Practice Address - Phone:305-801-0831
Practice Address - Fax:305-823-2428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies