Organization
COLUMBIA ANCILLARY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN D KLINGERMAN (PRESIDENT)
(570) 784-1410
Entity
Organization
Contact information
Practice address
RR #1 BOX 414, COLUMBIA ANCILLARY SERVICES INC, MOUNT CLARE, WV 26408
(304) 622-2635
(304) 622-2271
Mailing address
1388 STATE ROUTE 487, BLOOMSBURG, PA 17815
(570) 784-1410
(800) 326-8307
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
PA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
PA
332BX2000X
Oxygen Equipment & Supplies (DME)
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810008843
—
PA
Enumeration date
12/28/2006
Last updated
05/15/2008
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