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Organization
LIFE GUARD INC.
Active
Organization
LIFE GUARD INC.
Active
Other names
Wetzel Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MATT SHIVELY (V.P.)
(304) 665-2346
Entity
Organization
Contact information
Practice address
299 1/2 NORTH STATE ROUTE 2, NEW MARTINSVILLE, WV 26155
(304) 455-0250
(304) 455-0250
Mailing address
299 1/2 NORTH STATE ROUTE 2, NEW MARTINSVILLE, WV 26155
(304) 455-0250
(304) 455-0250
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
NONE REQUIRED
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6202086001
—
WV
Enumeration date
12/12/2006
Last updated
07/14/2009
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