Provider Demographics
NPI:1124898333
Name:HOME FRONT PUMPS
Entity type:Organization
Organization Name:HOME FRONT PUMPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:KAILAS
Authorized Official - Last Name:BRIHMADESAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-681-4141
Mailing Address - Street 1:124 UNIONVILLE INDIAN TRAIL RD W STE A4
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5592
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:124 UNIONVILLE INDIAN TRAIL RD W STE A4
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5592
Practice Address - Country:US
Practice Address - Phone:704-286-9918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies