Organization
PCH HOME MEDICAL SUPPLIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA NOWLIN (DME MANAGER)
(276) 694-2479
Entity
Organization
Contact information
Practice address
835 WOODLAND DR, SUITE 100, STUART, VA 24171-1586
(276) 694-2479
(276) 694-3833
Mailing address
835 WOODLAND DR, SUITE 100, STUART, VA 24171-1586
(276) 694-2479
(276) 694-3833
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0206009325
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000197677
ANTHEM
VA
01
—
TRICARE
203652687 24171 0000
VA
Enumeration date
08/12/2006
Last updated
08/22/2020
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