| NPI | 1609952423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM E CLARKE President 304-589-3178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: WV 018764) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WV 018764) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: WV 018764) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: WV 018764) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2011-10-26 |