Healthcare Provider Details
I. General information
NPI: 1417913625
Provider Name (Legal Business Name): LYNCH DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/25/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8159 US HIGHWAY 60 W
LEWISPORT KY
42351-7081
US
IV. Provider business mailing address
PO BOX 365
LEWISPORT KY
42351-0365
US
V. Phone/Fax
- Phone: 270-295-7262
- Fax: 270-295-7270
- Phone: 270-295-7262
- Fax: 270-295-7270
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
KAREN
AMMON
Title or Position: OFFICE MANAGER
Credential:
Phone: 270-295-7262