Provider Demographics
NPI:1629484266
Name:HIGHRISE MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:HIGHRISE MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:AYERS-RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-694-4447
Mailing Address - Street 1:PO BOX 4596
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37602-4596
Mailing Address - Country:US
Mailing Address - Phone:844-694-4447
Mailing Address - Fax:844-694-4447
Practice Address - Street 1:3900 BRISTOL HWY STE B3
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1378
Practice Address - Country:US
Practice Address - Phone:844-694-4447
Practice Address - Fax:844-694-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies