Provider Demographics
NPI:1215903547
Name:HOME THERAPY PRODUCTS, INC.
Entity type:Organization
Organization Name:HOME THERAPY PRODUCTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE- PRESIDENT OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:TYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-644-6200
Mailing Address - Street 1:PO BOX 66149
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-0020
Mailing Address - Country:US
Mailing Address - Phone:904-644-6200
Mailing Address - Fax:904-644-6201
Practice Address - Street 1:2580-2 COUNTY ROAD 220
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-6532
Practice Address - Country:US
Practice Address - Phone:904-644-6200
Practice Address - Fax:904-644-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1314332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0227111 00Medicaid
FL0929430001Medicare ID - Type Unspecified