Healthcare Provider Details

I. General information

NPI: 1386685097
Provider Name (Legal Business Name): PRO-MED HOME MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 WOOD AVE E
BIG STONE GAP VA
24219-3018
US

IV. Provider business mailing address

PO BOX 811
BIG STONE GAP VA
24219-0811
US

V. Phone/Fax

Practice location:
  • Phone: 276-523-5500
  • Fax: 276-523-5560
Mailing address:
  • Phone: 276-523-5500
  • Fax: 276-523-5560

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. MICHAEL KEVIN DALTON
Title or Position: PRESIDENT / OWNER
Credential:
Phone: 276-523-5500