Healthcare Provider Details

I. General information

NPI: 1700791779
Provider Name (Legal Business Name): MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 2ND ST # 100
RICHMOND KY
40475-1408
US

IV. Provider business mailing address

212 N 2ND ST # 100
RICHMOND KY
40475-1408
US

V. Phone/Fax

Practice location:
  • Phone: 346-771-1189
  • Fax:
Mailing address:
  • Phone: 346-771-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SYED OMRAN LNU
Title or Position: DME
Credential:
Phone: 346-771-1189