Provider Demographics
NPI:1861729196
Name:HOME CARE X-RAY SERVICES INC
Entity type:Organization
Organization Name:HOME CARE X-RAY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:877-972-9225
Mailing Address - Street 1:PO BOX 4992
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33775-4992
Mailing Address - Country:US
Mailing Address - Phone:877-972-9225
Mailing Address - Fax:877-972-9327
Practice Address - Street 1:266 TAMIAMI TRAIL S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285
Practice Address - Country:US
Practice Address - Phone:877-972-9225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC8533335V00000X, 261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier