Provider Demographics
NPI:1699752667
Name:HOMEFRONT RESOURCES INC
Entity type:Organization
Organization Name:HOMEFRONT RESOURCES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRYNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-241-5555
Mailing Address - Street 1:950 PENINSULA CORPORATE CIR
Mailing Address - Street 2:SUITE 1016
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1385
Mailing Address - Country:US
Mailing Address - Phone:561-241-5555
Mailing Address - Fax:561-241-5777
Practice Address - Street 1:950 PENINSULA CORPORATE CIR
Practice Address - Street 2:SUITE 1016
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1385
Practice Address - Country:US
Practice Address - Phone:561-241-5555
Practice Address - Fax:561-241-5777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1066170001Medicare NSC