Provider Demographics
NPI:1497703516
Name:HOME MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:HOME MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAGOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-751-3700
Mailing Address - Street 1:8600 PARK MEADOWS DR
Mailing Address - Street 2:SUITE 50
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2756
Mailing Address - Country:US
Mailing Address - Phone:303-751-3700
Mailing Address - Fax:866-428-8900
Practice Address - Street 1:8600 PARK MEADOWS DR STE 50
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2734
Practice Address - Country:US
Practice Address - Phone:303-751-3700
Practice Address - Fax:866-428-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X
CO41-21053-0000332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ018085Medicaid
MT5607043Medicaid
MS00183014Medicaid
CO32650736Medicaid
MD406990100Medicaid
NY02713537Medicaid
UT=========001Medicaid
MD406990100Medicaid
IL=========001Medicaid