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General NPI Number Information
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NPI Number | 1346236239
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Entity Type | Organization
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Legal Business Name | LARCO MEDICAL INC
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Dates
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Enumeration Date | 09/26/2005
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 405 N WILLOW AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2338
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Country | US
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Telephone | 931-528-7573
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Fax | 931-526-6383
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Provider Business Mailing Address
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Address Line | 405 N WILLOW AVE
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City | COOKEVILLE
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State | TN
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Zip | 38501-2338
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Country | US
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Telephone | 931-528-7573
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Fax | 931-526-6383
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Authorized Official
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Title or Position | CFO
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Name | MR. JAMES BARRY HELM
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Credential |
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Telephone | 931-528-7573
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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 | 0000000504
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License Number State | TN
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