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General NPI Number Information
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NPI Number | 1548328909
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Entity Type | Organization
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Legal Business Name | LILLYS HOME MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 479 N VANCE DR
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City | BECKLEY
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State | WV
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Zip | 25801-4158
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Country | US
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Telephone | 304-255-0925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1148
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City | BECKLEY
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State | WV
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Zip | 25802-1148
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Country | US
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Telephone | 304-255-0925
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Fax | 304-255-1005
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Authorized Official
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Title or Position | CEO
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Name | MARTHA JANE LILLY
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Credential |
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Telephone | 304-255-0925
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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 |
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License Number State | WV
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