Home Bound Healthcare Medical Equipment & Supplies, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203.000910 Issued in IL

Legal business name

HOME BOUND HEALTHCARE MEDICAL EQUIPMENT & SUPPLIES, LLC

Practice address

2307 W Lake St
Melrose Park, IL 60160-3622

Phone

(708) 615-0800

Fax

(708) 615-0808

NPI assigned

Aug 23, 2007

Last updated

Mar 9, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Julieta R Mitra

Title

President/Secretary/Treasurer

Phone

(708) 615-0800

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1962695924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 W LAKE ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603622",
            "telephone_number": "708-615-0800",
            "fax_number": "708-615-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 W LAKE ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603622",
            "telephone_number": "708-615-0800",
            "fax_number": "708-615-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME BOUND HEALTHCARE MEDICAL EQUIPMENT & SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "MITRA",
        "authorized_official_first_name": "JULIETA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/SECRETARY/TREASURER",
        "authorized_official_telephone_number": "708-615-0800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203.000910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.