Provider Demographics
NPI:1982639555
Name:PRO2 LEXINGTON, LLC
Entity Type:Organization
Organization Name:PRO2 LEXINGTON, LLC
Other - Org Name:PRO2 RESPIRATORY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-469-5771
Mailing Address - Street 1:198 MOORE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2944
Mailing Address - Country:US
Mailing Address - Phone:859-277-0029
Mailing Address - Fax:859-277-0112
Practice Address - Street 1:198 MOORE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2944
Practice Address - Country:US
Practice Address - Phone:859-277-0029
Practice Address - Fax:859-277-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90009267Medicaid
KY90009267Medicaid