Provider Demographics
NPI:1568441145
Name:LCM HOME HEALTH EQUIPMENT CENTER
Entity Type:Organization
Organization Name:LCM HOME HEALTH EQUIPMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-499-0071
Mailing Address - Street 1:5610 W 95 ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:708-499-0071
Mailing Address - Fax:708-499-4415
Practice Address - Street 1:5610 W 95 ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:708-499-0071
Practice Address - Fax:708-499-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI56647OtherNATIONAL PROVIDER NETWORK
ILL016420OtherTRICARE
IL131626700OtherUS DEPTARTMENT OF LABOR
IL1670691OtherBLUE CROSS BLUE SHIELD
IL455642OtherAETNA
IL56647OtherDMENSION
IL1670691OtherBLUE CROSS BLUE SHIELD
MI56647OtherNATIONAL PROVIDER NETWORK