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NPI 1124027222

NPI 1124027222 : CLAY HOME MEDICAL INC : FRANKLIN, VA

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General NPI Number Information
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    NPI Number           |    1124027222
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    Entity Type          |    Organization 
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    Legal Business Name  |    CLAY HOME MEDICAL INC 
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Dates
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    Enumeration Date     |    07/20/2005
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    Last Update Date     |    10/13/2025
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Provider Practice Location Address
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    Address Line         |    210 STEWART DR # 210 
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    City                 |    FRANKLIN
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    State                |    VA
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    Zip                  |    23851-2456
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    Country              |    US
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    Telephone            |    434-348-0888
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    Fax                  |    434-348-0988
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Provider Business Mailing Address
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    Address Line         |    555 E NORTH LN STE 5075 
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    City                 |    CONSHOHOCKEN
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    State                |    PA
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    Zip                  |    19428-2490
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CCO
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    Name                 |     WENDY  RUSSALESI 
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    Credential           |    
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    Telephone            |    484-246-9499
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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       |    
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    License Number State |    VA
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