Provider Demographics
NPI:1437788304
Name:LOCUST MEDICAL, LLC
Entity Type:Organization
Organization Name:LOCUST MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPADARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-461-4696
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-0315
Mailing Address - Country:US
Mailing Address - Phone:304-461-4696
Mailing Address - Fax:
Practice Address - Street 1:213 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-2330
Practice Address - Country:US
Practice Address - Phone:304-461-4696
Practice Address - Fax:347-708-1620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-03
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies