Organization
YOUR HOME TOWN MEDICAL EQUIPMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN A PEARSON JR. (OWNER)
(620) 670-6080
Entity
Organization
Contact information
Practice address
1615 N WALNUT ST, PITTSBURG, KS 66762-3049
(620) 670-6080
(620) 223-2374
Mailing address
1615 N WALNUT ST, PITTSBURG, KS 66762-3049
(620) 670-6080
(620) 223-2374
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
16103515
KS
332BC3200X
Customized Equipment (DME)
16103515
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118092
DME
KS
05
—
30003910720001
—
KS
05
—
30003910720002
—
KS
Enumeration date
07/08/2005
Last updated
05/28/2024
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