To start a Durable Medical Equipment (DME) business in West Virginia, it is essential to obtain the necessary licenses and certifications. First, you must register your business with the West Virginia Secretary of State and apply for a state business license. Next, you’ll need a sales tax permit from the State Tax Department to handle taxable items legally. If you plan to bill Medicare, obtaining DMEPOS accreditation from a CMS-approved accrediting body is mandatory. After that, you must enroll as a Medicare supplier and post a surety bond as required by CMS. Additionally, it’s crucial to comply with all state-specific regulations, such as maintaining a physical office location and specific operating hours. These certifications ensure that your business meets both state and federal requirements, builds credibility, and is eligible to serve patients and receive insurance reimbursements.