Provider Demographics
NPI:1770217721
Name:MEDIQUIP
Entity Type:Organization
Organization Name:MEDIQUIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-261-5131
Mailing Address - Street 1:841 S HIGHWAY 25 W STE 5
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-4600
Mailing Address - Country:US
Mailing Address - Phone:606-261-5131
Mailing Address - Fax:
Practice Address - Street 1:841 S HIGHWAY 25 W STE 5
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-4600
Practice Address - Country:US
Practice Address - Phone:606-261-5131
Practice Address - Fax:606-825-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies