Organization
FIELDS MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA KIRK (OWNER)
(606) 298-3674
Entity
Organization
Contact information
Practice address
2138 BLACKLOG ROAD, INEZ, KY 41224-0000
(606) 298-3674
(606) 298-0724
Mailing address
2138 BLACKLOG ROAD, INEZ, KY 41224-0000
(606) 298-3674
(606) 298-0724
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
083898
KY
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
083898
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45907813
EPSDT
KY
05
—
8855106000
—
WV
05
—
90100801
—
KY
Enumeration date
08/18/2005
Last updated
07/19/2011
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