Provider Demographics
NPI:1386850980
Name:HOMEDCO INC
Entity type:Organization
Organization Name:HOMEDCO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ELHASAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:313-386-0224
Mailing Address - Street 1:6852 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2008
Mailing Address - Country:US
Mailing Address - Phone:313-386-0224
Mailing Address - Fax:313-386-0225
Practice Address - Street 1:6852 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2008
Practice Address - Country:US
Practice Address - Phone:313-386-0224
Practice Address - Fax:313-386-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540H227740OtherBCBSM
MI4845274Medicaid
MI4845274Medicaid