Organization
MIDSTATE MEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAL A MCBEE JR. (VICE PRESIDENT)
(410) 643-3393
Entity
Organization
Contact information
Practice address
167 S MINERAL ST, KEYSER, WV 26726-2643
(304) 788-2335
Mailing address
RR 4 BOX 40, KEYSER, WV 26726-9404
(304) 788-2335
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
009458
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009717900004
—
PA
05
—
00419858100
—
MD
05
—
010472101
—
TX
05
—
0148368000
—
WV
01
—
046928500
BLACK LUNG
MH
05
—
41669200
—
WI
01
—
Z157
CAREFIRST BCBS
MD
Enumeration date
11/28/2006
Last updated
04/13/2009
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