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General NPI Number Information
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NPI Number | 1669435715
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Entity Type | Organization
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Legal Business Name | MOUNTAIN HOME CARE EQUIPMENT, INC.
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 200 INDUSTRIAL BLVD SUITE 113
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City | ELLIJAY
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State | GA
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Zip | 30540-3722
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Country | US
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Telephone | 706-635-4494
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Fax | 706-635-3910
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Provider Business Mailing Address
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Address Line | PO BOX 675
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City | ELLIJAY
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State | GA
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Zip | 30540-0009
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Country | US
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Telephone | 706-635-4494
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN RHODES
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Credential | CRRT/RRT
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Telephone | 706-635-4494
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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 |
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 332BX2000X
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License Number State | GA
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