Provider Demographics
NPI:1851667521
Name:LEE HEALTHCARE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:LEE HEALTHCARE MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:PARSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-646-7670
Mailing Address - Street 1:118 B SOUTHPARK DR.
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801
Mailing Address - Country:US
Mailing Address - Phone:325-646-7670
Mailing Address - Fax:325-646-7676
Practice Address - Street 1:118 B SOUTHPARK DR.
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801
Practice Address - Country:US
Practice Address - Phone:325-646-7670
Practice Address - Fax:325-646-7676
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEE HEALTHCARE MEDICAL SUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies