Healthcare Provider Details

I. General information

NPI: 1619024346
Provider Name (Legal Business Name): ASHLAND COMMUNITY MEDICAL EQUIPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 01/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WINCHESTER AVE
ASHLAND KY
41101-7832
US

IV. Provider business mailing address

2200 WINCHESTER AVE
ASHLAND KY
41101-7832
US

V. Phone/Fax

Practice location:
  • Phone: 606-324-1101
  • Fax: 606-325-2629
Mailing address:
  • Phone: 606-324-1101
  • Fax: 606-325-2629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. BRUCE ALAN DAVIS
Title or Position: PRESIDENT
Credential:
Phone: 606-324-1101