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General NPI Number Information
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NPI Number | 1043401060
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Entity Type | Organization
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Legal Business Name | LESLIE COUNTY DURABLE MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 4898 HIGHWAY 406
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City | STINNETT
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State | KY
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Zip | 40868-6513
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Country | US
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Telephone | 606-374-6873
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Fax | 606-374-6873
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Provider Business Mailing Address
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Address Line | 4898 HIGHWAY 406
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City | STINNETT
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State | KY
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Zip | 40868-6513
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Country | US
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Telephone | 606-374-6873
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Fax | 606-374-6873
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. MARY LAVONNE MCINTOSH
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Credential |
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Telephone | 606-374-6873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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