Healthcare Provider Details

I. General information

NPI: 1831243799
Provider Name (Legal Business Name): CHERRICARE, MEDICAL EQUIP & SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BOLIVAR ST
OWENSBORO KY
42303-4246
US

IV. Provider business mailing address

401 BOLIVAR ST
OWENSBORO KY
42303-4246
US

V. Phone/Fax

Practice location:
  • Phone: 270-926-2522
  • Fax: 270-926-7647
Mailing address:
  • Phone: 270-926-2522
  • Fax: 270-926-7647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHERRI STONE LOLLEY
Title or Position: OWNER
Credential:
Phone: 270-926-2252