Organization Name: | LIFETIME MEDICAL SUPPLY INC. |
NPI Number: | 1497988984 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICK GELSTHORPE (PRESIDENT) |
Mailing Address: | 1215 N Ottercreek Rd. Streator |
State: | IL US |
Postal Code: | 61364 |
Phone Number: | 8156720670 |
Fax Number: | |
NPI Enumeration Date: | 08/31/2009 |
NPI Last Update Date: | 08/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |