Healthcare Provider Details

I. General information

NPI: 1154296689
Provider Name (Legal Business Name): COLLIER HOME MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 S CAROL MALONE BLVD
GRAYSON KY
41143-1352
US

IV. Provider business mailing address

146 S CAROL MALONE BLVD
GRAYSON KY
41143-1352
US

V. Phone/Fax

Practice location:
  • Phone: 606-458-1013
  • Fax: 740-574-4370
Mailing address:
  • Phone: 606-458-1013
  • Fax: 740-574-4370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. BRUCE SCOTT MAYS
Title or Position: GENERAL MANAGER
Credential:
Phone: 740-574-0327