Organization
TAMARACK LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN H JOHNSON JR. (CEO)
(304) 255-6500
Entity
Organization
Contact information
Practice address
386 RAGLAND RD, BECKLEY, WV 25801-9722
(304) 255-6500
(304) 253-5420
Mailing address
PO BOX 1102, BECKLEY, WV 25802-1102
(304) 255-6500
(304) 253-5420
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0148499000
—
WV
Enumeration date
04/21/2006
Last updated
09/07/2012
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