Provider Demographics
NPI:1497537203
Name:COLLIER HOME MEDICAL LLC
Entity Type:Organization
Organization Name:COLLIER HOME MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:740-574-8738
Mailing Address - Street 1:1661 STATE ROUTE 522 UNIT 3
Mailing Address - Street 2:
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-8120
Mailing Address - Country:US
Mailing Address - Phone:740-574-8738
Mailing Address - Fax:740-529-1455
Practice Address - Street 1:1661 STATE ROUTE 522 UNIT 3
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-8120
Practice Address - Country:US
Practice Address - Phone:740-574-8738
Practice Address - Fax:740-529-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies