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Organization
BLACK BEAR MEDICAL, INC.
Active
Organization
BLACK BEAR MEDICAL, INC.
Active
Other names
Quipt Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY CRAWFORD (AUTHORIZED OFFICIAL)
(859) 300-6455
Entity
Organization
Contact information
Practice address
275 MARGINAL WAY, PORTLAND, ME 04101-2542
(207) 871-0008
(207) 871-0590
Mailing address
1019 TOWN DR, HIGHLAND HEIGHTS, KY 41076-9114
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
1019767
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128710000
—
ME
05
—
131150000
—
ME
Enumeration date
06/23/2005
Last updated
10/13/2025
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