Organization
HOME MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI LYNN WOLFF (OWNER PRESIDENT)
(708) 258-9880
Entity
Organization
Contact information
Practice address
422 SOUTH GOVERNORS HIGHWAY, SUITE 15, PEOTONE, IL 60468-9113
(708) 259-9880
(708) 258-9888
Mailing address
422 SOUTH GOVERNORS HIGHWAY, PEOTONE, IL 60468-9113
(708) 259-9880
(708) 258-9888
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000119
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09923225
BCBS OF IL
IL
01
—
200293290A
MEDICAID
IN
Enumeration date
10/18/2006
Last updated
10/08/2008
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