Organization Name: | ACTIVE MEDICAL LLC |
NPI Number: | 1821418187 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT JOSEPH TANT (MEMBER/MANAGER) |
Mailing Address: | 3475 Teays Valley Rd Unit A Hurricane |
State: | WV US |
Postal Code: | 255269279 |
Phone Number: | 3043976599 |
Fax Number: | 3043976566 |
NPI Enumeration Date: | 04/24/2014 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |