Healthcare Provider Details

I. General information

NPI: 1871628131
Provider Name (Legal Business Name): LAYNE MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MILLARD ALLEN DRIVE
LACKEY KY
41643-0189
US

IV. Provider business mailing address

PO BOX 24483
LEXINGTON KY
40524-4483
US

V. Phone/Fax

Practice location:
  • Phone: 606-358-2230
  • Fax:
Mailing address:
  • Phone: 606-358-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number142576
License Number StateKY

VIII. Authorized Official

Name: MRS. DONNA L HUGHES
Title or Position: OWNER
Credential: MBA
Phone: 606-358-2230