Provider Demographics
NPI:1346236239
Name:LARCO MEDICAL INC
Entity Type:Organization
Organization Name:LARCO MEDICAL INC
Other - Org Name:LARCO MEDICAL INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:HELM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-528-7573
Mailing Address - Street 1:405 N WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-2338
Mailing Address - Country:US
Mailing Address - Phone:931-528-7573
Mailing Address - Fax:931-526-6383
Practice Address - Street 1:405 N WILLOW AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2338
Practice Address - Country:US
Practice Address - Phone:931-528-7573
Practice Address - Fax:931-526-6383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000504332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3548141Medicaid
TN0045535OtherBLUE CROSS BLUE SHIELD
TN80545OtherNORHTWOOD NPN
TN20204OtherABP ADMINISTRATION
TN3548141Medicaid