Organization
MY FAMILY MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY MATUSIC (OWNER)
(304) 757-1902
Entity
Organization
Contact information
Practice address
1101 HOSPITAL DR, SUITE 101, HURRICANE, WV 25526-8711
(304) 757-1902
(304) 757-1904
Mailing address
1101 HOSPITAL DR, SUITE 101, HURRICANE, WV 25526-8711
(304) 757-1902
(304) 757-1904
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
784978
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810004760
—
WV
Enumeration date
07/30/2006
Last updated
12/14/2010
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