Organization
LIFE GUARD INC.
Active
Other names
Pocahontas Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW P SHIVELY (VICE PRESIDENT)
(304) 665-2346
Entity
Organization
Contact information
Practice address
105 DUNCAN ROAD, MARLINTON, WV 24954
(304) 665-2346
(304) 665-9402
Mailing address
208 RIVERVIEW DR., BELMONT, WV 26134
(304) 665-2346
(304) 665-9402
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810014683
—
WV
Enumeration date
11/19/2008
Last updated
06/11/2009
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