Provider Demographics
NPI:1154695716
Name:MEDICAL EQUIPMENT INSPECTION & REPAIR
Entity type:Organization
Organization Name:MEDICAL EQUIPMENT INSPECTION & REPAIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARYLA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:417-683-2030
Mailing Address - Street 1:RT 6 BOX 6292
Mailing Address - Street 2:
Mailing Address - City:AVA
Mailing Address - State:MO
Mailing Address - Zip Code:65608
Mailing Address - Country:US
Mailing Address - Phone:417-683-2030
Mailing Address - Fax:417-683-2030
Practice Address - Street 1:122 EAST WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:AVA
Practice Address - State:MO
Practice Address - Zip Code:65608
Practice Address - Country:US
Practice Address - Phone:417-683-2030
Practice Address - Fax:417-683-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO21319928332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies