Provider Demographics
NPI:1669232419
Name:ELACHAR, LLC
Entity type:Organization
Organization Name:ELACHAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:WICKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-732-1701
Mailing Address - Street 1:117 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2803
Mailing Address - Country:US
Mailing Address - Phone:276-632-3198
Mailing Address - Fax:276-632-3199
Practice Address - Street 1:117 BROAD ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2803
Practice Address - Country:US
Practice Address - Phone:276-632-3198
Practice Address - Fax:276-632-3199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment