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Organization

MID VALLEY SUPPLY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CARLTON E HOUCK (PRESIDENT/OWNER)
(570) 696-8754
Entity
Organization

Contact information

Practice address
170 BLUEBERRY HILL RD, SHAVERTOWN, PA 18708-9507
(570) 696-9754
(570) 696-9756
Mailing address
170 BLUEBERRY HILL RD, SHAVERTOWN, PA 18708-9507
(570) 696-9754
(570) 696-9756

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
03/02/2018
Last updated
03/02/2018
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