Provider Demographics
NPI:1487611810
Name:APPALACHIAN MEDICAL EQUIPMENT CO., INC.
Entity type:Organization
Organization Name:APPALACHIAN MEDICAL EQUIPMENT CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:EULA
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-727-5421
Mailing Address - Street 1:4050 HIGHWAY 67 W
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683-6013
Mailing Address - Country:US
Mailing Address - Phone:423-727-5421
Mailing Address - Fax:423-727-5018
Practice Address - Street 1:4050 HIGHWAY 67 W
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-6013
Practice Address - Country:US
Practice Address - Phone:423-727-5421
Practice Address - Fax:423-727-5018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000407332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1454114Medicaid
TN3543201Medicaid
TX0005301042OtherAETNA
MD460203OtherFEDERAL BLACK LUNG
TN1454114Medicaid
TN3543201Medicaid