Organization
ADVANTAGE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL DAWN COULTER (MANAGER)
(304) 587-9992
Entity
Organization
Contact information
Practice address
151 MAIN STREET, CLAY, WV 25043
(304) 587-9994
(304) 587-9993
Mailing address
PO BOX 835, 151 MAIN STREET, CLAY, WV 25043
(304) 587-9992
(304) 587-9993
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2247-5308
WV
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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