Provider Demographics
NPI:1740337195
Name:CREECH FURNITURE GALLERIES
Entity type:Organization
Organization Name:CREECH FURNITURE GALLERIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CREECH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-368-4050
Mailing Address - Street 1:610 KINGSHIGHWAY ST
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-2951
Mailing Address - Country:US
Mailing Address - Phone:573-368-4050
Mailing Address - Fax:573-341-0205
Practice Address - Street 1:610 KINGSHIGHWAY ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2951
Practice Address - Country:US
Practice Address - Phone:573-368-4050
Practice Address - Fax:573-341-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4107740001Medicare NSC