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NPI Code Detail

MEDICARE: FAMILY LIFE MEDICAL AND PROSTHETICS LLC

MEDICARE: FAMILY LIFE MEDICAL AND PROSTHETICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies105540KY

General Provider Information

NPI Number : 1609998442
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY LIFE MEDICAL AND PROSTHETICS LLC
Provider Business Mailing Address
First Line : 300 MAPLE ST
Second Line : SUITE 107
City : MURRAY
State : KY
Zip : 42071-2540
Country : US
Telephone Number : 270-217-0798
Fax Number :
Provider Business Practice Location Address
First Line : 300 MAPLE ST
Second Line : SUITE 107
City : MURRAY
State : KY
Zip : 42071-2540
Country : US
Telephone Number : 270-217-0798
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. PAULA J. GREEN
Credential : RN
Telephone Number : 270-217-0798
Provider Enumeration Date : 04/04/2007
Last Update Date : 08/22/2020

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Directions to “FAMILY LIFE MEDICAL AND PROSTHETICS LLC ” Practice Location

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