Provider Demographics
NPI:1013162999
Name:HUNT, TERESA DARLENE (DME)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:DARLENE
Last Name:HUNT
Suffix:
Gender:F
Credentials:DME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SHADY SPRING
Mailing Address - State:WV
Mailing Address - Zip Code:25918
Mailing Address - Country:US
Mailing Address - Phone:304-860-1446
Mailing Address - Fax:304-860-1447
Practice Address - Street 1:286 PINE ST
Practice Address - Street 2:
Practice Address - City:SHADY SPRING
Practice Address - State:WV
Practice Address - Zip Code:25918
Practice Address - Country:US
Practice Address - Phone:304-860-1446
Practice Address - Fax:304-860-1447
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVT36441332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810014286Medicaid
WV3810014286Medicaid