Provider Demographics
NPI:1790908317
Name:UNLIMITED LLC
Entity Type:Organization
Organization Name:UNLIMITED LLC
Other - Org Name:UNDIE BOX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:STACY
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED FITTER
Authorized Official - Phone:859-268-1267
Mailing Address - Street 1:PO BOX 21807
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40522-1807
Mailing Address - Country:US
Mailing Address - Phone:859-268-1267
Mailing Address - Fax:859-268-0039
Practice Address - Street 1:3371 MOUNDVIEW CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-3515
Practice Address - Country:US
Practice Address - Phone:859-268-1267
Practice Address - Fax:859-268-0039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000478319OtherANTHEM BLUE CROSS
KY000000478319OtherANTHEM BLUE CROSS