# LIFE SUPPLY CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diversified Medical Equipment Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891856506
- **Authorized official:** MR. JOSEPH SMITH (CEO PRESIDEN)
- **Authorized official phone:** (203) 239-1002

## Contact information

- **Practice address:** 143 MILL ST, LEOMINSTER, MA 01453-3242
- **Practice address phone:** (978) 537-8707
- **Practice address fax:** (978) 537-9196
- **Mailing address:** 280 MOODY ST, LUDLOW, MA 01056-1244
- **Mailing address phone:** (413) 593-5555
- **Mailing address fax:** (413) 593-9530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | MA | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 01/24/2022