Organization
KAREN AMMON
Active
Other names
SENIOR MOBILITY AND MEDICAL SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN AMMON (PRESIDENT)
(270) 298-0046
Entity
Organization
Contact information
Practice address
100 N MAIN ST, HARTFORD, KY 42347-1123
(270) 298-0046
(270) 298-0079
Mailing address
PO BOX 480, HARTFORD, KY 42347-0480
(270) 298-0046
(270) 298-0079
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000475146
ANTHEM
—
01
—
50017879
PASSPORT HEALTH PLAN
KY
05
—
90012022
—
KY
Enumeration date
04/27/2006
Last updated
06/16/2008
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