Provider Demographics
NPI:1497815195
Name:C&M HOMECARE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:C&M HOMECARE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:606-377-2001
Mailing Address - Street 1:PO BOX 291
Mailing Address - Street 2:SUITE 9521
Mailing Address - City:MC DOWELL
Mailing Address - State:KY
Mailing Address - Zip Code:41647-0291
Mailing Address - Country:US
Mailing Address - Phone:606-377-2001
Mailing Address - Fax:606-377-6424
Practice Address - Street 1:KY HWY 122
Practice Address - Street 2:SUITE 9521
Practice Address - City:MC DOWELL
Practice Address - State:KY
Practice Address - Zip Code:41647-0291
Practice Address - Country:US
Practice Address - Phone:606-377-2001
Practice Address - Fax:606-377-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90040361Medicaid
KY90040361Medicaid