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General NPI Number Information
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NPI Number | 1639695539
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Entity Type | Organization
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Legal Business Name | CARDINAL MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 515 OGDEN ST STE C
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City | SOMERSET
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State | KY
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Zip | 42501-1736
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Country | US
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Telephone | 606-305-5558
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Fax | 888-818-6245
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Provider Business Mailing Address
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Address Line | 515 OGDEN ST STE C
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City | SOMERSET
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State | KY
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Zip | 42501-1736
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Country | US
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Telephone | 606-305-5558
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Fax | 888-818-6245
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY B PIERCE
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Credential |
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Telephone | 606-305-5558
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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 | KY
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