Healthcare Provider Details

I. General information

NPI: 1063414571
Provider Name (Legal Business Name): JL WEBB DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 31 W BYPASS STE 401
BOWLING GREEN KY
42101
US

IV. Provider business mailing address

330 31 W BYPASS STE 401
BOWLING GREEN KY
42101
US

V. Phone/Fax

Practice location:
  • Phone: 270-746-5745
  • Fax: 270-746-5747
Mailing address:
  • Phone: 270-746-5745
  • Fax: 270-746-5747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number226929
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateKY

VIII. Authorized Official

Name: MR. JAMES L WEBB
Title or Position: OWNER/CEO
Credential:
Phone: 270-746-5745