Provider Demographics
NPI:1790960854
Name:LCM ENTERPRISES
Entity Type:Organization
Organization Name:LCM ENTERPRISES
Other - Org Name:MAC-LIN MEDICAL SUPPLY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MACMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-947-5666
Mailing Address - Street 1:1008 STILLWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-947-5666
Mailing Address - Fax:207-947-0948
Practice Address - Street 1:1008 STILLWATER AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-5023
Practice Address - Country:US
Practice Address - Phone:207-947-5666
Practice Address - Fax:207-947-0948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME6047210001Medicare NSC