Healthcare Provider Details

I. General information

NPI: 1053017871
Provider Name (Legal Business Name): SVVM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E WASHITA ST
SPRINGFIELD MO
65804-2355
US

IV. Provider business mailing address

1515 E WASHITA ST
SPRINGFIELD MO
65804-2355
US

V. Phone/Fax

Practice location:
  • Phone: 417-343-3545
  • Fax:
Mailing address:
  • Phone: 417-343-3545
  • Fax:

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: TERESA LYNNE MAUREN
Title or Position: OPERATING OFFICER
Credential: RN
Phone: 417-343-3545