Organization
MOUNTAIN HOME CARE EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN RHODES CRRT/RRT (OWNER)
(706) 635-4494
Entity
Organization
Contact information
Practice address
200 INDUSTRIAL BLVD, SUITE 113, ELLIJAY, GA 30540-3722
(706) 635-4494
(706) 635-3910
Mailing address
PO BOX 675, ELLIJAY, GA 30540-0009
(706) 635-4494
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
332BX2000X
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00319503A
—
GA
05
—
00649129A
—
GA
Enumeration date
04/10/2006
Last updated
07/24/2007
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