Organization
KANAWHA MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYANE B PERGERSON (VICE PRESIDENT)
(804) 330-5743
Entity
Organization
Contact information
Practice address
7009 FOREST HILL AVE, RICHMOND, VA 23225-1607
(804) 330-5743
(804) 330-7149
Mailing address
7009 FOREST HILL AVE, RICHMOND, VA 23225-1607
(804) 330-5743
(804) 330-7149
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
0206008452
VA
Other
Enumeration date
12/22/2006
Last updated
08/22/2020
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