Organization Name: | HOME MEDICAL SUPPLY OF POPLAR BLUFF, INC. |
NPI Number: | 1790780781 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MYLYNN GARGAC (BILLING SUPERVISOR) |
Mailing Address: | 1901 Sunset Dr Poplar Bluff |
State: | MO US |
Postal Code: | 639012820 |
Phone Number: | 8006825510 |
Fax Number: | 5736865510 |
NPI Enumeration Date: | 06/16/2005 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |