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Organization
MERCHANT HOME MEDICAL SERVICES,LLC
Active
Organization
MERCHANT HOME MEDICAL SERVICES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY LYNN LEWIS DENMARK (OWNER)
(540) 931-4211
Entity
Organization
Contact information
Practice address
105 W CENTRAL AVE, VALDOSTA, GA 31601-5508
(229) 257-0024
(229) 247-8200
Mailing address
PO BOX 1167, VALDOSTA, GA 31603-1167
(229) 257-0024
(229) 247-8200
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHRE0085835
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000912513A
—
GA
01
—
PHRE008535
RETAIL PHARMACY
GA
Enumeration date
01/05/2007
Last updated
07/10/2023
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