Provider Demographics
NPI:1679193882
Name:LIL DME LLC
Entity Type:Organization
Organization Name:LIL DME LLC
Other - Org Name:THE LIL' DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAMEZ-BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-337-0182
Mailing Address - Street 1:980886 S OAKTREE RD
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OK
Mailing Address - Zip Code:74881-8108
Mailing Address - Country:US
Mailing Address - Phone:956-337-0182
Mailing Address - Fax:
Practice Address - Street 1:20 E 9TH ST STE 101
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6987
Practice Address - Country:US
Practice Address - Phone:405-788-4416
Practice Address - Fax:405-725-1598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies