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Organization

HOMECARE MEDICAL GROUPS LLC

Active
Other names
Homecare Medical Groups LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRYAN TYSON (REGISTERED AGENT)
(919) 494-2207
Entity
Organization

Contact information

Practice address
10429 LIGON MILL RD, WAKE FOREST, NC 27587-4987
(919) 556-7500
(888) 891-4170
Mailing address
10429 LIGON MILL RD, WAKE FOREST, NC 27587-4987
(919) 556-7500
(888) 891-4170

Taxonomy

Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
NC
251B00000X
Case Management Agency
NC
251C00000X
Developmentally Disabled Services Day Training Agency
NC
251G00000X
Community Based Hospice Care Agency
NC
251S00000X
Community/Behavioral Health Agency
NC
252Y00000X
Early Intervention Provider Agency
NC
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
000000
NC
332BN1400X
Nursing Facility Supplies (DME)
000000
NC
332BX2000X
Oxygen Equipment & Supplies (DME)
000000
NC
332U00000X
Home Delivered Meals
000000
NC
335E00000X
Prosthetic/Orthotic Supplier
343900000X
Non-emergency Medical Transport (VAN)
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7790000
NC
01
BREAST PROSTHETICS
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS
NC
01
CERTIFIED PEDORTHIST
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS
NC
01
FEDERALLY ACCREDITED
HEALTHCARE QUALITY ASSOCIATION ON ACCREDITATION
NC
Enumeration date
09/10/2007
Last updated
07/21/2011
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