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NPI Code Detail

MEDICARE: LIFE CARE HOME MEDICAL EQUIPMENT, LLC

MEDICARE: LIFE CARE HOME MEDICAL EQUIPMENT, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies11441OH

General Provider Information

NPI Number : 1417255308
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFE CARE HOME MEDICAL EQUIPMENT, LLC
Provider Business Mailing Address
First Line : PO BOX 1111
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-1111
Country : US
Telephone Number : 740-355-2273
Fax Number : 740-776-2273
Provider Business Practice Location Address
First Line : 729 6TH ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4030
Country : US
Telephone Number : 740-355-2273
Fax Number : 740-776-2273
Authorized Official
Title or Position : PRESIDENT
Name : MR. CALVIN D AVERY
Credential :
Telephone Number : 740-354-6169
Provider Enumeration Date : 03/02/2011
Last Update Date : 09/08/2011

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Directions to “LIFE CARE HOME MEDICAL EQUIPMENT, LLC ” Practice Location

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