Provider Demographics
NPI:1316022296
Name:MEDISERVE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:MEDISERVE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-477-9807
Mailing Address - Street 1:PO BOX 8839
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615
Mailing Address - Country:US
Mailing Address - Phone:423-477-9806
Mailing Address - Fax:423-477-3571
Practice Address - Street 1:3200 FT HENRY DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664
Practice Address - Country:US
Practice Address - Phone:423-477-9806
Practice Address - Fax:423-477-3571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies