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MOUNTAINEER HOME MEDICAL LLC NPI 1760474852


NPI Information

NPI: 1760474852
Provider Name: MOUNTAINEER HOME MEDICAL, LLC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
5000 GREENBAG ROAD
SUITE F6
MORGANTOWN, WV
ZIP 26501
Phone: (304) 225-6290
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MOUNTAINEER HOME MEDICAL, LLC is a durable medical equipment medical supplies in Morgantown, WV. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. MOUNTAINEER HOME MEDICAL, LLC NPI is 1760474852. The provider is registered as an organization entity type.

The provider's business location address is:

5000 GREENBAG ROAD
SUITE F6
MORGANTOWN, WV
ZIP 26501
Phone: (304) 225-6290
Fax: (304) 225-1115

The provider's authorized official is Michelle L Jackson .
The authorized official title is Billing Specialist and has the following contact phone number (304) 225-6290.

The enumeration date for this NPI number is 8/16/2005 and was last updated on 5/19/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical Supplies770649WEST VIRGINIANo
2332B00000XDurable Medical Equipment & Medical SuppliesCONTROLNUMBER72117WEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1001704877OTHERWEST VIRGINIABLUE CROSS BLUE SHIELD
2407251100MEDICAIDMARYLAND
33810001835MEDICAIDWEST VIRGINIA
4DME315OTHERWEST VIRGINIAHEALTH PLAN PROVIDER #
5101294177 0001MEDICAIDPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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