MEDICARE: KANAWHA MEDICAL SUPPLY

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
1	251E00000X	Home Health Agency		VA

Other Identifiers

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

General Provider Information

NPI Number	:	1558746198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANAWHA MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	7009 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1607
Country	:	US
Telephone Number	:	804-330-5743
Fax Number	:	804-330-7149

Provider Business Practice Location Address
First Line	:	7009 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1607
Country	:	US
Telephone Number	:	804-330-5743
Fax Number	:	804-330-7149

Authorized Official
Title or Position	:	DIRECT OWNER/CFO
Name	:	MR. WILLIAM CARL PERGERSONA
Credential	:
Telephone Number	:	804-330-5743

Provider Enumeration Date	:	07/24/2015
Last Update Date	:	07/24/2015

Similar Medicare Providers

1730176066 — MS. AUDRA SUE ANDERSON PHARMD
Practice Location Address:

7045 FOREST HILL AVE
RICHMOND, VA
23225-1607

Practice Phone: 804-272-2114
Practice Fax:

1134106578 — KANAWHA MEDICAL SUPPLY INC
Practice Location Address:

7009 FOREST HILL AVE
RICHMOND, VA
23225-1607

Practice Phone: 804-330-5937
Practice Fax: 804-330-7149

1578503983 — GIANT FOOD STORES, LLC
Practice Location Address:

7045 FOREST HILL AVE
RICHMOND, VA
23225-1607

Practice Phone: 804-272-2114
Practice Fax: 804-419-1707

1629133533 — KANAWHA MEDICAL SUPPLY, INC.
Practice Location Address:

7009 FOREST HILL AVE
RICHMOND, VA
23225-1607

Practice Phone: 804-330-5743
Practice Fax: 804-330-7149

1942582481 — MISS JESSICA AUSTIN SHAMBURGER MSP
Practice Location Address:

1607 WESTBURY DR
RICHMOND, VA
23229-4830

Practice Phone: 803-359-3195
Practice Fax:

1073917514 — STEPHANIE DECKARD
Practice Location Address:

1607 REEVESTON RD
RICHMOND, IN
47374-5642

Practice Phone: 817-909-7754
Practice Fax: 765-644-0510

Directions to “KANAWHA MEDICAL SUPPLY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.