Organization
AMERICAN HOMECARE SUPPLY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD L PARRA (PRESIDENT)
(570) 961-0155
Entity
Organization
Contact information
Practice address
150 MUNDY ST, MAC IV BUILDING, WILKES BARRE, PA 18702-6830
(570) 825-7600
(570) 825-7640
Mailing address
4113 BIRNEY AVE, MOOSIC, PA 18507-1301
(570) 961-0155
(570) 961-1802
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
3000007810
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016726890009
—
PA
Enumeration date
12/01/2005
Last updated
01/27/2009
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