Healthcare Provider Details

I. General information

NPI: 1942690680
Provider Name (Legal Business Name): JAMES MEDICAL EQUIPMENT, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 JOE T PETTY DRIVE SUITE A
RUSSELL SPRINGS KY
42642-8533
US

IV. Provider business mailing address

950 CAMPBELLSVILLE BYPASS
CAMPBELLSVILLE KY
42718-7869
US

V. Phone/Fax

Practice location:
  • Phone: 270-866-2070
  • Fax: 270-866-2071
Mailing address:
  • Phone: 270-465-8220
  • Fax: 270-789-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberMG0110
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM C MILBY JR.
Title or Position: TREASURY
Credential:
Phone: 207-465-8220