Organization
LUCKY STRIKE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EHIMWENMA K OWEN (MANAGING DIRECTOR)
(502) 291-4542
Entity
Organization
Contact information
Practice address
2258 W BROAD ST UNIT 1, COOKEVILLE, TN 38501-2263
(931) 854-0686
(931) 854-0692
Mailing address
2258 W BROAD ST UNIT 1, COOKEVILLE, TN 38501-2263
(931) 854-0686
(931) 854-0692
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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