Provider Demographics
NPI:1619351749
Name:LB MEDICAL SUPPLY AND EQUIPMENT LLC
Entity Type:Organization
Organization Name:LB MEDICAL SUPPLY AND EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MGR
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BRAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-851-6866
Mailing Address - Street 1:532 KNOX ABBOTT DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CAYCE
Mailing Address - State:SC
Mailing Address - Zip Code:29033-4161
Mailing Address - Country:US
Mailing Address - Phone:803-851-6866
Mailing Address - Fax:
Practice Address - Street 1:532 KNOX ABBOTT DR
Practice Address - Street 2:SUITE 1
Practice Address - City:CAYCE
Practice Address - State:SC
Practice Address - Zip Code:29033-4161
Practice Address - Country:US
Practice Address - Phone:803-851-6866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies