| Organization Name: | BURKESVILLE MEDICAL SUPPLY, INC |
| NPI Number: | 1417066424 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY LYNN WHITE (OWNER CEO) |
| Mailing Address: | 365 Keen St Burkesville |
| State: | KY US |
| Postal Code: | 427170006 |
| Phone Number: | 2708642230 |
| Fax Number: | 2708642691 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 03/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BN1400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Nursing Facility Supplies |
| Taxonomy Definition: | |