Healthcare Provider Details

I. General information

NPI: 1508863390
Provider Name (Legal Business Name): L&M MEDICAL EQUIPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 MEDICAL LN
WHITLEY CITY KY
42653-4216
US

IV. Provider business mailing address

PO BOX 31
MARSHES SIDING KY
42631-0031
US

V. Phone/Fax

Practice location:
  • Phone: 606-376-4444
  • Fax: 606-376-3444
Mailing address:
  • Phone: 606-376-8715
  • Fax: 606-376-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number165788
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JERRY L PENNINGTON
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 606-376-8715