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General NPI Number Information
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NPI Number | 1366491177
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Entity Type | Organization
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Legal Business Name | PIKEVILLE MEDICAL EQUIPMENT & SUPPLIES, INC.
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 789A N MAYO TR
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City | PIKEVILLE
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State | KY
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Zip | 41501-1686
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Country | US
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Telephone | 606-432-6011
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Fax | 606-432-6085
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Provider Business Mailing Address
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Address Line | PO BOX 3816
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City | PIKEVILLE
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State | KY
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Zip | 41502-3816
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Country | US
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Telephone | 606-432-6011
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Fax | 606-432-6085
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Authorized Official
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Title or Position | CEO
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Name | MRS. SHELIA GOODMAN WATSON
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Credential |
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Telephone | 606-432-6011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | NOT REQUIRED IN KY
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License Number State | KY
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