Provider Demographics
NPI:1316208051
Name:EPK MEDICAL LLC
Entity Type:Organization
Organization Name:EPK MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-576-0779
Mailing Address - Street 1:370 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2406
Mailing Address - Country:US
Mailing Address - Phone:859-576-0779
Mailing Address - Fax:859-554-5766
Practice Address - Street 1:370 ANDOVER DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2406
Practice Address - Country:US
Practice Address - Phone:859-576-0779
Practice Address - Fax:859-554-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies