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General NPI Number Information
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NPI Number | 1619076296
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Entity Type | Organization
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Legal Business Name | LINCOLN MEDICAL SUPPLY, INC.
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 1815 N DIXIE HWY SUITE 1
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-9424
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Country | US
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Telephone | 270-769-0317
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Fax | 270-769-0318
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Provider Business Mailing Address
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Address Line | 1815 N DIXIE AVE STE 103
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-9424
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Country | US
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Telephone | 270-769-0317
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Fax | 270-769-0318
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MOHAMMED Q SAJID
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Credential |
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Telephone | 270-769-0317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 268229
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License Number State | KY
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