Organization
LEXINGTON DIABETIC CENTER PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C ALLEN DPM (CEO)
(859) 977-8855
Entity
Organization
Contact information
Practice address
1401 HARRODSBURG RD, B280, LEXINGTON, KY 40504-3751
(859) 977-8855
(859) 977-8856
Mailing address
1401 HARRODSBURG RD, B280, LEXINGTON, KY 40504-3751
(859) 977-8855
(859) 977-8856
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
31364
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5214980001
LDC DMERC REGION B
KY
Enumeration date
03/24/2008
Last updated
03/24/2008
Update your record
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