Provider Demographics
NPI:1700862455
Name:MAC'S MEDICAL EQUIPMENT AND SUPPLIES, INC.
Entity Type:Organization
Organization Name:MAC'S MEDICAL EQUIPMENT AND SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAC
Authorized Official - Middle Name:R
Authorized Official - Last Name:CLIFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-628-6800
Mailing Address - Street 1:611 CAMPUS DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-9700
Mailing Address - Country:US
Mailing Address - Phone:276-623-4260
Mailing Address - Fax:
Practice Address - Street 1:611 CAMPUS DR
Practice Address - Street 2:SUITE 400
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-9700
Practice Address - Country:US
Practice Address - Phone:276-623-4260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0467560001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT