Provider Demographics
NPI:1437245685
Name:LOWRY MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:LOWRY MEDICAL SUPPLY, INC
Other - Org Name:DME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGESCU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-331-0036
Mailing Address - Street 1:1717 ORANGE AVE UNIT 3942
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34948-2448
Mailing Address - Country:US
Mailing Address - Phone:615-331-0036
Mailing Address - Fax:615-866-0190
Practice Address - Street 1:150 SPACE PARK S BLDG A-6
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3123
Practice Address - Country:US
Practice Address - Phone:615-331-0036
Practice Address - Fax:615-866-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4112378OtherTENNCARE SELECT
TNQ017317Medicaid
TN4112378OtherBLUE CROSS BLUE SHIELD
KY90262585Medicaid
TN166393600OtherDEPT OF LABOR PROVIDER NU
TN5660070001Medicare NSC