| Organization Name: | SOUTHWEST VIRGINIA HOME MEDICAL, LLC |
| NPI Number: | 1629021225 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIM R DAUGHERTY (MEMBER) |
| Mailing Address: | 134 Cecil D Quillen Dr Duffield |
| State: | VA US |
| Postal Code: | 242449726 |
| Phone Number: | 2764310202 |
| Fax Number: | 2764310203 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 08/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 0206009338 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |