Provider Demographics
NPI:1437188315
Name:CYPRESS HOME MEDICAL INC
Entity type:Organization
Organization Name:CYPRESS HOME MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT AND ASST. SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ZSITEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:3911 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0039
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:847-913-9024
Practice Address - Street 1:11341 LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8852
Practice Address - Country:US
Practice Address - Phone:239-561-3456
Practice Address - Fax:239-561-4164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHHA20885096251E00000X
FLPH0015307332B00000X, 332BP3500X, 332BX2000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106200001-01 (DME)Medicaid
FL106200000 (RX)Medicaid
FL106200001-01 (DME)Medicaid
1166550001Medicare NSC