Organization
MEDLEY VITAL CARE INFUSION, INC.
Active
Other names
MEDLEY VITAL CARE INFUSION
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA MITCHELL (MANAGER)
(573) 437-3440
Entity
Organization
Contact information
Practice address
601 EAST HWY 28, OWENSVILLE, MO 65066
(573) 437-3440
(573) 437-4963
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
005817
MO
332BC3200X
Customized Equipment (DME)
005817
MO
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
005817
MO
332BX2000X
Oxygen Equipment & Supplies (DME)
005817
MO
333600000X
Pharmacy
005817
MO
3336C0003X
Community/Retail Pharmacy
005817
MO
3336H0001X
Home Infusion Therapy Pharmacy
005817
MO
3336L0003X
Long Term Care Pharmacy
005817
MO
3336M0002X
Mail Order Pharmacy
005817
MO
3336S0011X
Specialty Pharmacy
005817
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29836
BCBS
—
Enumeration date
08/29/2006
Last updated
03/05/2010
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