PCH Home Medical Supplies, LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

0206009325 Issued in VA

Legal business name

PCH HOME MEDICAL SUPPLIES, LLC

Practice address

835 Woodland Dr
Suite 100
Stuart, VA 24171-1586

Phone

(276) 694-2479

Fax

(276) 694-3833

NPI assigned

Aug 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pamela Nowlin

Title

DME Manager

Phone

(276) 694-2479

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598777161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 WOODLAND DR",
            "address_2": "SUITE 100",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241711586",
            "telephone_number": "276-694-2479",
            "fax_number": "276-694-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 WOODLAND DR",
            "address_2": "SUITE 100",
            "city": "STUART",
            "state": "VA",
            "postal_code": "241711586",
            "telephone_number": "276-694-2479",
            "fax_number": "276-694-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCH HOME MEDICAL SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOWLIN",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "DME MANAGER",
        "authorized_official_telephone_number": "276-694-2479"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "VA",
            "license": "0206009325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0000000197677",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "203652687 24171 0000",
            "identifier": "TRICARE",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• PCH Operations, LLC Dba R.J. Reynolds-Patrick County Memorial Hospital

• Oxygen Equipment & Supplies (DME) in Stuart, VA
• Providers in Stuart, VA by specialty
• Oxygen Equipment & Supplies (DME) in 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.