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Organization

LIFE GUARD INC.

Active
Other names
Wetzel Home Medical
Organization subpart
No

Provider details

NPI number
Authorized official
MATT SHIVELY (V.P.)
(304) 665-2346
Entity
Organization

Contact information

Practice address
299 1/2 NORTH STATE ROUTE 2, NEW MARTINSVILLE, WV 26155
(304) 455-0250
(304) 455-0250
Mailing address
299 1/2 NORTH STATE ROUTE 2, NEW MARTINSVILLE, WV 26155
(304) 455-0250
(304) 455-0250

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
NONE REQUIRED

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6202086001
WV
Enumeration date
12/12/2006
Last updated
07/14/2009
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