Organization
LILLYS HOME MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA JANE LILLY (CEO)
(304) 255-0925
Entity
Organization
Contact information
Practice address
479 N VANCE DR, BECKLEY, WV 25801-4158
(304) 255-0925
Mailing address
PO BOX 1148, BECKLEY, WV 25802-1148
(304) 255-0925
(304) 255-1005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146663000
—
WV
Enumeration date
12/05/2006
Last updated
07/21/2022
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