Provider Demographics
NPI:1871826891
Name:DME
Entity Type:Organization
Organization Name:DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:502-814-3174
Mailing Address - Street 1:2301 RIVER RD
Mailing Address - Street 2:302
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2093
Mailing Address - Country:US
Mailing Address - Phone:502-426-9680
Mailing Address - Fax:
Practice Address - Street 1:2301 RIVER RD
Practice Address - Street 2:302
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2093
Practice Address - Country:US
Practice Address - Phone:502-426-9680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies