Healthcare Provider Details

I. General information

NPI: 1487823753
Provider Name (Legal Business Name): DURABLE MEDICAL SUPPLY HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 SOUTHGATE PLAZA
MAYSVILLE KY
41056
US

IV. Provider business mailing address

1335 SOUTHGATE PLAZA
MAYSVILLE KY
41056
US

V. Phone/Fax

Practice location:
  • Phone: 606-564-3081
  • Fax: 606-563-0786
Mailing address:
  • Phone: 606-564-3081
  • Fax: 606-563-0786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. RITA GOLDMAN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 606-564-3081