Organization
KATHLEEN S. ELLIS
Active
Other names
Boone HomeCare Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN S ELLIS (OWNER/MANAGER)
(304) 369-7964
Entity
Organization
Contact information
Practice address
327 STATE ST, MADISON, WV 25130-1367
(304) 369-7964
(304) 369-7005
Mailing address
327 STATE ST, PO BOX 98, MADISON, WV 25130-1367
(304) 369-7964
(304) 369-7005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
001
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0147485000
—
WV
Enumeration date
10/25/2006
Last updated
07/21/2022
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