Provider Demographics
NPI:1689672875
Name:L&M MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:L&M MEDICAL EQUIPMENT, INC
Other - Org Name:PULMONARY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-376-8715
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:MARSHES SIDING
Mailing Address - State:KY
Mailing Address - Zip Code:42631-0031
Mailing Address - Country:US
Mailing Address - Phone:606-376-8715
Mailing Address - Fax:606-376-8715
Practice Address - Street 1:928 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1480
Practice Address - Country:US
Practice Address - Phone:859-985-8585
Practice Address - Fax:859-985-8781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2009-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY165788332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90269077Medicaid
KY0297010005Medicare ID - Type Unspecified