MEDICARE: L&M 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)
2	332B00000X	Durable Medical Equipment & Medical Supplies	165788	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508863390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L&M MEDICAL EQUIPMENT, INC

Provider Business Mailing Address
First Line	:	PO BOX 31
Second Line	:
City	:	MARSHES SIDING
State	:	KY
Zip	:	42631-0031
Country	:	US
Telephone Number	:	606-376-8715
Fax Number	:	606-376-3444

Provider Business Practice Location Address
First Line	:	68 MEDICAL LN
Second Line	:
City	:	WHITLEY CITY
State	:	KY
Zip	:	42653-4216
Country	:	US
Telephone Number	:	606-376-4444
Fax Number	:	606-376-3444

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	JERRY L PENNINGTON
Credential	:
Telephone Number	:	606-376-8715

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	09/23/2009

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