Provider Demographics
NPI:1114069861
Name:REGION MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:REGION MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-327-1377
Mailing Address - Street 1:225 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:MO
Mailing Address - Zip Code:65275
Mailing Address - Country:US
Mailing Address - Phone:660-327-1377
Mailing Address - Fax:660-327-1378
Practice Address - Street 1:225 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:MO
Practice Address - Zip Code:65275
Practice Address - Country:US
Practice Address - Phone:660-327-1377
Practice Address - Fax:660-327-1378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO626015705Medicaid
MO626015705Medicaid