Provider Demographics
NPI:1215100532
Name:HUEY'S HOME MEDICAL
Entity type:Organization
Organization Name:HUEY'S HOME MEDICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-663-2727
Mailing Address - Street 1:503 N PROSPECT RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-3516
Mailing Address - Country:US
Mailing Address - Phone:217-663-2727
Mailing Address - Fax:217-663-1818
Practice Address - Street 1:2003 ROUND BARN RD
Practice Address - Street 2:SUITES A & B
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-6827
Practice Address - Country:US
Practice Address - Phone:217-356-4839
Practice Address - Fax:217-356-5190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUEY'S HOME MEDICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000633332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies