NPIMap

Organization Active NPI

Kanawha Medical Supply, Inc.

  • Customized Equipment (DME)
  • Richmond, VA
National Provider Identifier
1629133533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
0206008452 Issued in VA
Legal business name
KANAWHA MEDICAL SUPPLY, INC.
Practice address
7009 Forest Hill Ave
Richmond, VA 23225-1607
Phone
(804) 330-5743
Fax
(804) 330-7149
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dyane B Pergerson
Title
Vice President
Phone
(804) 330-5743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 0206008452 VA Primary

Addresses

Primary practice location

7009 Forest Hill Ave
Richmond, VA 23225-1607

Mailing address

7009 Forest Hill Ave
Richmond, VA 23225-1607
Phone (804) 330-5743

National Provider Directory

National Provider Directory
Tax ID family
Kanawha Medical Supply Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7009 Forest Hill Ave
Richmond, VA 23225
Phone (804) 330-5743

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629133533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7009 FOREST HILL AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251607",
            "telephone_number": "804-330-5743",
            "fax_number": "804-330-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7009 FOREST HILL AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232251607",
            "telephone_number": "804-330-5743",
            "fax_number": "804-330-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANAWHA MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PERGERSON",
        "authorized_official_first_name": "DYANE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "804-330-5743"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "VA",
            "license": "0206008452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • 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.