Provider Demographics
NPI:1861400798
Name:HOMELAND LP
Entity type:Organization
Organization Name:HOMELAND LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:GILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-536-6001
Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75833-1309
Mailing Address - Country:US
Mailing Address - Phone:903-536-6001
Mailing Address - Fax:903-536-6004
Practice Address - Street 1:143 S CASS STREET
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TX
Practice Address - Zip Code:75833
Practice Address - Country:US
Practice Address - Phone:903-536-6001
Practice Address - Fax:903-536-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0082099332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4518050001Medicare ID - Type Unspecified