Provider Demographics
NPI:1053315788
Name:EPPY'S IV, INC
Entity Type:Organization
Organization Name:EPPY'S IV, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER, IV MANAGER, PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BACHO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-252-6332
Mailing Address - Street 1:2987 A ROBERT C. BYRD DRIVE
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801
Mailing Address - Country:US
Mailing Address - Phone:304-252-6332
Mailing Address - Fax:304-252-0145
Practice Address - Street 1:2987 A ROBERT C. BYRD DRIVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801
Practice Address - Country:US
Practice Address - Phone:304-252-6332
Practice Address - Fax:304-252-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV251F00000X
332B00000X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5010854OtherNABP #
WV0144296000Medicaid
WV0286460001Medicare UPIN