MEDICARE: DME 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000313763	OTHER	KY	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2444604000	OTHER	KY	PASSPORT ADVANTAGE
4	50002827	OTHER	KY	PASSPORT HEALTH PLAN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801858378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DME LLC

Provider Business Mailing Address
First Line	:	510 E PARRISH AVE
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-3125
Country	:	US
Telephone Number	:	270-688-5888
Fax Number	:	270-688-8238

Provider Business Practice Location Address
First Line	:	510 E PARRISH AVE
Second Line	:
City	:	OWENSBORO
State	:	KY
Zip	:	42303-3125
Country	:	US
Telephone Number	:	270-688-5888
Fax Number	:	270-688-8238

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	RUBY ROBERTS
Credential	:
Telephone Number	:	270-688-5888

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	06/03/2026

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Directions to “DME LLC ” Practice Location

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