Provider Demographics
NPI:1952948002
Name:ALEXANDRIA DURABLE MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:ALEXANDRIA DURABLE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DILLON
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-663-0698
Mailing Address - Street 1:8242 ALEXANDRIA PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-1162
Mailing Address - Country:US
Mailing Address - Phone:859-908-0690
Mailing Address - Fax:
Practice Address - Street 1:8242 ALEXANDRIA PIKE STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001-1162
Practice Address - Country:US
Practice Address - Phone:859-908-0690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies