Organization
FAYETTE HOME HEALTH CARE SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BAXTER (OWNER)
(931) 375-1775
Entity
Organization
Contact information
Practice address
134 W COURT ST, WASHINGTON COURT HOUSE, OH 43160-1326
(740) 636-0720
Mailing address
134 W COURT ST, WASHINGTON COURT HOUSE, OH 43160-1326
(740) 636-0720
(740) 636-0780
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000257998
ANTHEM
OH
05
—
0954409
—
OH
Enumeration date
06/02/2005
Last updated
12/16/2025
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