Organization
BREATHITT COUNTY HOME MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY EUGENE SMITH (OWNER)
(606) 693-0939
Entity
Organization
Contact information
Practice address
726 HIGHWAY 15 N STE 2, JACKSON, KY 41339
(606) 693-0939
(606) 693-0938
Mailing address
726 HIGHWAY 15 N STE 2, JACKSON, KY 41339-8601
(606) 693-0939
(606) 693-0938
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MG0424
KY
Other
Enumeration date
07/11/2006
Last updated
01/18/2019
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