Provider Demographics
NPI:1699128157
Name:US HOMEMED, LLC
Entity type:Organization
Organization Name:US HOMEMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER-RHODE ISLAND
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-915-4870
Mailing Address - Street 1:56 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-2819
Mailing Address - Country:US
Mailing Address - Phone:401-486-3388
Mailing Address - Fax:401-861-6190
Practice Address - Street 1:56 PINE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2819
Practice Address - Country:US
Practice Address - Phone:401-486-3388
Practice Address - Fax:401-861-6190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US HOMEMED, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7560001Medicaid