Provider Demographics
NPI:1669469797
Name:MID-VALLEY MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:MID-VALLEY MEDICAL EQUIPMENT INC
Other - Org Name:HHK MEDICAL ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-609-5385
Mailing Address - Street 1:12 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:PA
Mailing Address - Zip Code:18644-2028
Mailing Address - Country:US
Mailing Address - Phone:570-609-5385
Mailing Address - Fax:570-609-5387
Practice Address - Street 1:12 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:PA
Practice Address - Zip Code:18644-2028
Practice Address - Country:US
Practice Address - Phone:570-609-5385
Practice Address - Fax:570-609-5387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA434648OtherBLACK LUNG
PA0012629850003Medicaid
PA218286OtherBLUE CROSS
PA0012629850003Medicaid