Provider Demographics
NPI:1598229353
Name:MEDLY HEALTH SOLUTIONS LLC
Entity Type:Organization
Organization Name:MEDLY HEALTH SOLUTIONS LLC
Other - Org Name:MEDLY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-625-1036
Mailing Address - Street 1:802 BUFFALO ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6901
Mailing Address - Country:US
Mailing Address - Phone:304-625-1036
Mailing Address - Fax:
Practice Address - Street 1:802 BUFFALO ST STE 3A
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6901
Practice Address - Country:US
Practice Address - Phone:304-625-1036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies