MEDICARE: COLUMBIA MEDICAL EQUIPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)	MG0399	KY
2	332BD1200X	Dialysis Equipment & Supplies (DME)	MG0399	KY
3	332BN1400X	Nursing Facility Supplies (DME)	MG0399	KY
4	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	MG0399	KY
5	332B00000X	Durable Medical Equipment & Medical Supplies	MG0399	KY
6	332BX2000X	Oxygen Equipment & Supplies (DME)	MG0399	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215938733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBIA MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 550
Second Line	:
City	:	COLUMBIA
State	:	KY
Zip	:	42728-0550
Country	:	US
Telephone Number	:	270-384-5143
Fax Number	:	270-384-2003

Provider Business Practice Location Address
First Line	:	92 JOE T PETTY DR
Second Line	:	SUITE 700
City	:	RUSSELL SPRINGS
State	:	KY
Zip	:	42642-8543
Country	:	US
Telephone Number	:	270-866-6994
Fax Number	:	270-866-7011

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BARRY FROST
Credential	:
Telephone Number	:	270-384-5143

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	05/02/2012

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