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Organization

PACK MEDICAL INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHARLES FRANKLIN VANOVER (CEO/PRESIDENT)
(606) 920-9701
Entity
Organization

Contact information

Practice address
1653 GREENUP AVE, ASHLAND, KY 41101-7615
(606) 920-9701
(606) 920-9716
Mailing address
PO BOX 2203, ASHLAND, KY 41105-2203
(606) 920-9701
(606) 920-9716

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000070191
BCBS PROVIDER
KY
05
0183037
OH
05
6264014000
WV
05
90060104
KY
Enumeration date
04/26/2006
Last updated
07/21/2022
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