Life Guard Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

LIFE GUARD INC.

Doing business as

Pocahontas Home Medical

Practice address

105 Duncan Road
Marlinton, WV 24954

Phone

(304) 665-2346

Fax

(304) 665-9402

NPI assigned

Nov 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Matthew P Shively

Title

Vice President

Phone

(304) 665-2346

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pocahontas Home Medical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1255586111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 RIVERVIEW DR.",
            "city": "BELMONT",
            "state": "WV",
            "postal_code": "26134",
            "telephone_number": "304-665-2346",
            "fax_number": "304-665-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 DUNCAN ROAD",
            "city": "MARLINTON",
            "state": "WV",
            "postal_code": "24954",
            "telephone_number": "304-665-2346",
            "fax_number": "304-665-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE GUARD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-19",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "SHIVELY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "304-665-2346",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810014683",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pocahontas Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Penny Kershner
• Kinetic Connections, LLC
• Kayla Nicole Lester, PA-C
• Alisha Dawn Lewis
• Julie D. Leyzorek Hare, MD
• Matthew D Long
• Samantha Madison
• John Monroe Mallow Jr., D.D.S.
• Marlinton Volunteer Fire Department
• Benjamin Martin

• Oxygen Equipment & Supplies (DME) in Marlinton, WV
• Providers in Marlinton, WV by specialty
• Oxygen Equipment & Supplies (DME) in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.