Healthcare Provider Details

I. General information

NPI: 1063528339
Provider Name (Legal Business Name): INNOVATIVE MEDICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 FALLS DR NW
ABINGDON VA
24210-8093
US

IV. Provider business mailing address

303 FALLS DR NW
ABINGDON VA
24210-8093
US

V. Phone/Fax

Practice location:
  • Phone: 276-676-3133
  • Fax: 276-676-0818
Mailing address:
  • Phone: 276-676-3133
  • Fax: 276-676-0818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0206009127
License Number StateVA

VIII. Authorized Official

Name: MS. NANCY TAYLOR MARTIN
Title or Position: OWNER
Credential: RRT
Phone: 276-676-3133