Healthcare Provider Details

I. General information

NPI: 1053315788
Provider Name (Legal Business Name): EPPY'S IV, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2987 A ROBERT C. BYRD DRIVE
BECKLEY WV
25801
US

IV. Provider business mailing address

2987 A ROBERT C. BYRD DRIVE
BECKLEY WV
25801
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-6332
  • Fax: 304-252-0145
Mailing address:
  • Phone: 304-252-6332
  • Fax: 304-252-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARY E BACHO
Title or Position: PART OWNER, IV MANAGER, PHARMACIST
Credential: RPH
Phone: 304-252-6332