Provider Demographics
NPI:1841863396
Name:PENNYRILE HOME MEDICAL
Entity type:Organization
Organization Name:PENNYRILE HOME MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESNUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-885-2500
Mailing Address - Street 1:217 BURLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-8725
Mailing Address - Country:US
Mailing Address - Phone:270-885-2500
Mailing Address - Fax:270-889-9431
Practice Address - Street 1:830 FAIRVIEW AVE STE B5
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-4912
Practice Address - Country:US
Practice Address - Phone:270-393-9393
Practice Address - Fax:270-393-9383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies