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General NPI Number Information
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NPI Number | 1508059015
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Entity Type | Organization
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Legal Business Name | FOWLER & MAYFIELD ENTERPRISES, INC
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Dates
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Enumeration Date | 08/20/2007
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 3501 BRIDGEGATE CT
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City | LOUISVILLE
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State | KY
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Zip | 40272-2659
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Country | US
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Telephone | 502-306-9586
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Fax | 502-935-9547
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Provider Business Mailing Address
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Address Line | 3501 BRIDGEGATE CT
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City | LOUISVILLE
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State | KY
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Zip | 40272-2659
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Country | US
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Telephone | 502-306-9586
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Fax | 502-935-9547
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | ROBERT RAY FOWLER
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Credential |
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Telephone | 502-396-9586
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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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