Organization
MOUNTAINEER HOME MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JACKSON (COLLECTIONS MANAGER)
(304) 225-6290
Entity
Organization
Contact information
Practice address
220 N KANAWHA ST STE 3, BECKLEY, WV 25801-4745
(304) 225-6290
Mailing address
5000 GREENBAG RD, MORGANTOWN, WV 26501-7163
(304) 225-6290
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
06/07/2024
Last updated
05/01/2026
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