MEDICARE: MEDICARE RENTAL SUPPLY INC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)
4	335E00000X	Prosthetic/Orthotic Supplier
5	332B00000X	Durable Medical Equipment & Medical Supplies

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1427038009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICARE RENTAL SUPPLY INC

Provider Business Mailing Address
First Line	:	PO BOX 27968
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0968
Country	:	US
Telephone Number	:	570-966-8030
Fax Number	:	570-966-8040

Provider Business Practice Location Address
First Line	:	6601 MACCORKLE AVE SE STE A
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-2923
Country	:	US
Telephone Number	:	304-965-8006
Fax Number	:	304-965-8007

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. ROBIN L MENCHEN
Credential	:
Telephone Number	:	407-822-4600

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	03/14/2025

6609 MACCORKLE AVE SE
CHARLESTON, WV
25304-2923

Practice Phone: 304-925-5439
Practice Fax: 304-925-5980