Provider Demographics
NPI:1760885743
Name:LANCOUR BIZ, LLC
Entity Type:Organization
Organization Name:LANCOUR BIZ, LLC
Other - Org Name:SUPPORT HOSE PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:LANCOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-359-4078
Mailing Address - Street 1:2300 BELL ST
Mailing Address - Street 2:SUIT 2
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4601
Mailing Address - Country:US
Mailing Address - Phone:806-359-4078
Mailing Address - Fax:806-331-8571
Practice Address - Street 1:2300 BELL ST
Practice Address - Street 2:SUIT 2
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4601
Practice Address - Country:US
Practice Address - Phone:806-359-4078
Practice Address - Fax:806-331-8571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7255150001Medicare NSC