Organization
DANA R. HUNTINGTON
Active
Other names
Stateline Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA R. HUNTINGTON (OWNER)
(765) 732-3947
Entity
Organization
Contact information
Practice address
630 LIBERTY AVENUE, WEST COLLEGE CORNER, IN 47003-9308
(765) 732-3947
(765) 732-3940
Mailing address
630 LIBERTY AVENUE, WEST COLLEGE CORNER, IN 47003-9308
(765) 732-3947
(765) 732-3940
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200838850A
—
IN
05
—
2899029
—
OH
05
—
2902989
—
OH
Enumeration date
09/25/2008
Last updated
03/22/2009
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