Provider Demographics
NPI:1588376511
Name:PEAK MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:PEAK MEDICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANNING
Authorized Official - Middle Name:
Authorized Official - Last Name:EACHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-972-4504
Mailing Address - Street 1:6614 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-7811
Mailing Address - Country:US
Mailing Address - Phone:304-638-3168
Mailing Address - Fax:
Practice Address - Street 1:6614 COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-7811
Practice Address - Country:US
Practice Address - Phone:304-638-3168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies