# MOUNTAINEER HOME MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MOUNTAINEER HOME MEDICAL, LLC
- **Other names:** Round Table Health Care LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1518720754
- **Legal business name:** MOUNTAINEER HOME MEDICAL, LLC
- **Authorized official:** MICHELLE JACKSON (BILLING MANAGER)
- **Authorized official phone:** (304) 225-6290

## Contact information

- **Practice address:** 4039 CARATOKE HWY, BARCO, NC 27917-9520
- **Practice address phone:** (304) 225-6290
- **Mailing address:** 4039 CARATOKE HWY, BARCO, NC 27917-9520
- **Mailing address phone:** (252) 319-3448
- **Mailing address fax:** (252) 324-5747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 01/31/2024
- **Last updated:** 05/01/2026