Provider Demographics
NPI:1285675231
Name:LMS MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:LMS MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUPE
Authorized Official - Middle Name:DOVE
Authorized Official - Last Name:SWEEDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-484-9448
Mailing Address - Street 1:3204 TYRE NECK RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-3315
Mailing Address - Country:US
Mailing Address - Phone:757-484-9448
Mailing Address - Fax:757-484-9318
Practice Address - Street 1:3204 TYRE NECK RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3315
Practice Address - Country:US
Practice Address - Phone:757-484-9448
Practice Address - Fax:757-484-9318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24972332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9119621Medicaid
VA9119621Medicaid