Organization · NPI-2
Mid Valley Supply LLC
Durable Medical Equipment & Medical Supplies · Shavertown, PA
NPI number1881196285
StatusActive
Last updated in NPPESMar 2, 2018
Details
- NPI
- 1881196285
- Entity type
- Organization (NPI-2)
- Legal business name
- Mid Valley Supply LLC
- Organization subpart
- No
- Enumeration date
- Mar 2, 2018
- Last updated
- Mar 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – | Yes |
Practice location
170 Blueberry Hill RdShavertown, PA 18708-9507
Phone 570-696-9754 · Fax 570-696-9756
Mailing address
170 Blueberry Hill RdShavertown, PA 18708-9507
Phone 570-696-9754 · Fax 570-696-9756
Authorized official
Carlton E Houck
President/Owner
5706968754
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.