Provider Demographics
NPI:1285071969
Name:TIM'S HOME MEDICAL OF ST MARY'S, INC
Entity type:Organization
Organization Name:TIM'S HOME MEDICAL OF ST MARY'S, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-294-1284
Mailing Address - Street 1:685 KINGSBAY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3889
Mailing Address - Country:US
Mailing Address - Phone:912-882-7227
Mailing Address - Fax:912-882-8827
Practice Address - Street 1:685 KINGSBAY RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3889
Practice Address - Country:US
Practice Address - Phone:912-882-7227
Practice Address - Fax:912-882-8827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6909950001Medicare NSC