Provider Demographics
NPI:1578646766
Name:LIFEAID MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:LIFEAID MEDICAL EQUIPMENT LLC
Other - Org Name:LIFEAID MEDICAL EQUIPMENT LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:DORCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-566-1674
Mailing Address - Street 1:PO BOX 550309
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-0309
Mailing Address - Country:US
Mailing Address - Phone:931-455-0111
Mailing Address - Fax:
Practice Address - Street 1:1241 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-4385
Practice Address - Country:US
Practice Address - Phone:931-455-0111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0546260001Medicare ID - Type Unspecified