In Home Care LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

IN HOME CARE LLC

Doing business as

Life Guard Medical Supply

Practice address

108 Pullman Dr
Pennsboro, WV 26415

Phone

(304) 659-3535

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Mary Gale Clevenger

Title

Owner

Phone

(304) 659-3535

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Life Guard Medical Supply Doing business as

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376567859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "address_2": "108 PULLMAN DRIVE",
            "city": "PENNSBORO",
            "state": "WV",
            "postal_code": "26415",
            "telephone_number": "304-659-3535",
            "fax_number": "304-659-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PULLMAN DR",
            "city": "PENNSBORO",
            "state": "WV",
            "postal_code": "26415",
            "telephone_number": "304-659-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLEVENGER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "GALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-659-3535",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002357",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Guard Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Ray Flanagan
• Jonathan Brent Gaston
• Carla Goff
• Tabitha Ann Goff
• Home Sweet Home in Home Medical LLC (Life Guard Medical Supply)
• Nancy Marie Jones
• Shasta Jones
• Patricia Diane Lamp
• James Edward Levos, M.D.
• Cathy McKinney

• Durable Medical Equipment & Medical Supplies in Pennsboro, WV
• Providers in Pennsboro, WV by specialty
• Durable Medical Equipment & Medical Supplies in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.