Organization
STONEWALL HOME OXYGEN THERAPY, INC.
Active
Other names
SHOT
Organization subpart
No
Provider details
NPI number
Authorized official
MARY JANE EISENBEIS (DIRECTOR OF EXTERNAL OPERATIONS)
(304) 269-0100
Entity
Organization
Contact information
Practice address
456 MARKET PLACE MALL, SUITE A, WESTON, WV 26452-6938
(304) 269-0100
(304) 269-4559
Mailing address
456 MARKET PLACE MALL, SUITE A, WESTON, WV 26452-6938
(304) 269-0100
(304) 269-4559
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3910001067
—
WV
Enumeration date
10/09/2013
Last updated
11/13/2014
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