Provider Demographics
NPI:1134107808
Name:FRIENDSHIP HOME HEALTH INC
Entity Type:Organization
Organization Name:FRIENDSHIP HOME HEALTH INC
Other - Org Name:FRIENDSHIP HOME MEDICAL EQUIPMENT INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-328-2500
Mailing Address - Street 1:PO BOX 2410
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293
Mailing Address - Country:US
Mailing Address - Phone:276-328-2500
Mailing Address - Fax:276-328-3117
Practice Address - Street 1:BEN BOLT PROFESSIONAL PARK
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651
Practice Address - Country:US
Practice Address - Phone:276-988-7911
Practice Address - Fax:276-988-4942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4649846OtherAETNA
80520OtherNORTHWOOD NPN
147034OtherBCBS/ANTHEM VA
20093OtherABP ADMINISTRATION
WV0147422000Medicaid
WV0147422000Medicaid