Organization
MOUNTAINEER HOME MEDICAL, LLC
Active
Parent organization
MOUNTAINEER HOME MEDICAL, LLC
Other names
Round Table Health Care LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOUNTAINEER HOME MEDICAL, LLC
Authorized official
MICHELLE JACKSON (BILLING MANAGER)
(304) 225-6290
Entity
Organization
Contact information
Practice address
4039 CARATOKE HWY, BARCO, NC 27917-9520
(304) 225-6290
Mailing address
4039 CARATOKE HWY, BARCO, NC 27917-9520
(252) 319-3448
(252) 324-5747
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518720754
—
NC
Enumeration date
01/31/2024
Last updated
05/01/2026
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