MEDICARE: PLEASANT VALLEY HOME MEDICAL EQUIPMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457494775
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT VALLEY HOME MEDICAL EQUIPMENT

Provider Business Mailing Address
First Line	:	1011 VIAND ST
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-1242
Country	:	US
Telephone Number	:	304-675-6100
Fax Number	:	304-675-8018

Provider Business Practice Location Address
First Line	:	1011 VIAND ST
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-1242
Country	:	US
Telephone Number	:	304-675-6100
Fax Number	:	304-675-8018

Authorized Official
Title or Position	:	CFO
Name	:	MR. RICHARD H. HOGAN
Credential	:	CEO
Telephone Number	:	304-675-4340

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	08/26/2015

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