Organization
HOMES OXYGEN MEDICAL EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HELEN ROSE PENDERGRAFT (OWNER)
(606) 365-2228
Entity
Organization
Contact information
Practice address
3025 US HIGHWAY 150 W, STANFORD, KY 40484-9640
(606) 365-2228
(606) 365-0098
Mailing address
PO BOX 358, STANFORD, KY 40484-0358
(606) 365-2228
(606) 365-0098
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000497142
ANTHEM BLUE CROSS
KY
05
—
90013707
—
KY
Enumeration date
06/15/2006
Last updated
07/21/2022
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