Provider Demographics
NPI:1376803601
Name:CHERRICARE, MEDICAL EQUIPMENT AND SUPPLIES
Entity Type:Organization
Organization Name:CHERRICARE, MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Name:BEAUTIFUL YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERRI
Authorized Official - Middle Name:STONE
Authorized Official - Last Name:LOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:270-926-2252
Mailing Address - Street 1:1002 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-4733
Mailing Address - Country:US
Mailing Address - Phone:270-926-4129
Mailing Address - Fax:270-686-7170
Practice Address - Street 1:1002 E 18TH ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-4733
Practice Address - Country:US
Practice Address - Phone:270-926-4129
Practice Address - Fax:270-686-7170
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHERRICARE, MEDICAL EQUIPMENT AND SUPPLIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier