Organization
EXTENDED MEDICAL, INC
Active
Other names
EHS MEDICAL EQUIPMENT & SUPPLIES
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN D HAYNES (CEO)
(573) 359-2930
Entity
Organization
Contact information
Practice address
110 NORTH HIGHWAY J, HAYTI, MO 63851
(573) 359-0403
(573) 359-2136
Mailing address
PO BOX 393, HAYTI, MO 63851-0393
(573) 359-2473
(573) 359-1304
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
628892507
—
MO
01
—
684749
HEALTHLINK DME NUMBER
—
Enumeration date
03/28/2007
Last updated
11/15/2013
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