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General NPI Number Information
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NPI Number | 1104832922
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Entity Type | Organization
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Legal Business Name | GENERATION'S HOME MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 1032 CLAYMONT DR
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City | LYNCHBURG
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State | VA
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Zip | 24502-4480
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Country | US
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Telephone | 434-455-5515
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Fax | 434-455-5517
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Provider Business Mailing Address
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Address Line | 1032 CLAYMONT DR
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City | LYNCHBURG
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State | VA
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Zip | 24502-4480
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Country | US
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Telephone | 434-455-5515
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Fax | 434-455-5517
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEONARD STATHAM GILLIAM III
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Credential |
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Telephone | 434-455-5515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0206009288
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License Number State | VA
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