Basic Information
Provider Information
NPI: 1659563948
EntityType: 2
ReplacementNPI:  
OrganizationName: PVHS HOME MEDICAL SUPPLY LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: MAJOR MEDICAL
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 W GERMANTOWN PIKE STE 250
Address2:  
City: PLYMOUTH MEETING
State: PA
PostalCode: 194621437
CountryCode: US
TelephoneNumber: 6106306357
FaxNumber:  
Practice Location
Address1: 4025 ST CLOUD DR STE 150
Address2:  
City: LOVELAND
State: CO
PostalCode: 805389313
CountryCode: US
TelephoneNumber: 9706696800
FaxNumber: 9707761966
Other Information
ProviderEnumerationDate: 08/10/2007
LastUpdateDate: 07/18/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: AEROCARE HOLDINGS LLC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  N SuppliersDurable Medical Equipment & Medical Supplies 
332BX2000X  Y SuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies

No ID Information.


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