Organization
BLACK BEAR MEDICAL NH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG CRAWFORD (AUTHORIZED OFFICIAL)
(859) 441-8876
Entity
Organization
Contact information
Practice address
437 PORTSMOUTH AVE STE 4, GREENLAND, NH 03840-2244
(603) 547-9053
(603) 430-3745
Mailing address
1019 TOWN DR, HIGHLAND HEIGHTS, KY 41076-9114
(859) 350-1035
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30766045
—
NH
Enumeration date
11/01/2007
Last updated
10/17/2023
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