Provider Demographics
NPI:1366510554
Name:HOME MEDICAL SPECIALTIES, INC.
Entity type:Organization
Organization Name:HOME MEDICAL SPECIALTIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:H
Authorized Official - Last Name:TALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-829-9813
Mailing Address - Street 1:200 CARLETON AVE STE F
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-1222
Mailing Address - Country:US
Mailing Address - Phone:518-348-3649
Mailing Address - Fax:
Practice Address - Street 1:200 CARLETON AVE STE F
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1222
Practice Address - Country:US
Practice Address - Phone:518-348-3649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01573931Medicaid