Provider Demographics
NPI:1295798189
Name:DICKENSON COUNTY HOME MEDICAL RENTALS, INC
Entity type:Organization
Organization Name:DICKENSON COUNTY HOME MEDICAL RENTALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:H
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:GENERAL MANAGER
Authorized Official - Phone:276-926-8899
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:CLINTWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24228
Mailing Address - Country:US
Mailing Address - Phone:276-926-8899
Mailing Address - Fax:276-926-6136
Practice Address - Street 1:142 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228
Practice Address - Country:US
Practice Address - Phone:276-926-8899
Practice Address - Fax:576-926-6136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0003894789332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1331173OtherUNITED MINE WORKERS
VA053455OtherANTHEM
VA009134662Medicaid
VA009134662Medicaid