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General NPI Number Information
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NPI Number | 1619652872
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Entity Type | Organization
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Legal Business Name | CALVARY HOME OXYGEN AND MEDICAL LLC
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 112 ROWE ST STE D
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City | DUBLIN
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State | GA
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Zip | 31021-5266
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Country | US
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Telephone | 478-595-0861
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Fax |
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Provider Business Mailing Address
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Address Line | 112 ROWE ST STE D
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City | DUBLIN
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State | GA
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Zip | 31021-5266
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Country | US
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Telephone | 478-205-5024
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Fax | 478-205-5025
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM COLUMBUS DOVER
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Credential |
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Telephone | 478-205-5024
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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 |
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