Organization
ACTIVE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JOSEPH TANT ATP (MEMBER/MANAGER)
(304) 389-1246
Entity
Organization
Contact information
Practice address
3890 TEAYS VALLEY RD, HURRICANE, WV 25526-9720
(304) 397-6599
(304) 397-6566
Mailing address
3890 TEAYS VALLEY RD, HURRICANE, WV 25526-9720
(304) 397-6599
(304) 397-6566
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/24/2014
Last updated
07/10/2019
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