Organization
CMV HOME MEDICAL SUPPLIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM JEFFERY MONTGOMERY (MEMBER)
(573) 333-3784
Entity
Organization
Contact information
Practice address
825 W 3RD ST STE A, CARUTHERSVILLE, MO 63830-1236
(537) 333-3784
(573) 333-3785
Mailing address
825 W 3RD ST STE A, CARUTHERSVILLE, MO 63830-1236
(537) 333-3784
(573) 333-3785
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
2001010194
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008511
—
MO
Enumeration date
10/20/2009
Last updated
03/25/2011
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