Healthcare Provider Details

I. General information

NPI: 1285789461
Provider Name (Legal Business Name): APPALACHIAN MEDICAL EQUIPMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 S MAYO TRL
PAINTSVILLE KY
41240-1384
US

IV. Provider business mailing address

818 S MAYO TRL
PAINTSVILLE KY
41240-1384
US

V. Phone/Fax

Practice location:
  • Phone: 606-789-8309
  • Fax: 606-789-1028
Mailing address:
  • Phone: 606-789-8309
  • Fax: 606-789-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number093575
License Number StateKY

VIII. Authorized Official

Name: JERRY DANIEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 606-789-8309