Provider Demographics
NPI:1790771772
Name:HORIZON MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:HORIZON MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:276-228-4702
Mailing Address - Street 1:974 E STUART DR
Mailing Address - Street 2:SUITE F.
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2463
Mailing Address - Country:US
Mailing Address - Phone:276-236-7102
Mailing Address - Fax:276-236-9204
Practice Address - Street 1:974 E STUART DR
Practice Address - Street 2:SUITE F.
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2463
Practice Address - Country:US
Practice Address - Phone:276-236-7102
Practice Address - Fax:276-236-9204
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON MEDICAL EQUIPMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-23
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206009129332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA179761OtherANTHEM
VA179761OtherANTHEM