Organization
MACON MEDICAL ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY HENSLEY (MANAGER)
(606) 878-1064
Entity
Organization
Contact information
Practice address
43 WACO DRIVE, SUIT 7, LONDON, KY 40741
(606) 878-1064
Mailing address
43 WACO DRIVE, SUIT 7, LONDON, KY 40741
(606) 878-1064
(606) 878-1060
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
18D2031301
KY
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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