Organization
MODERN THERAPY & GAS LLC
Active
Other names
Modern Therapy & Gas, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES KENNETH JOHNSON (OWNER)
(859) 326-0063
Entity
Organization
Contact information
Practice address
401 DANVILLE ST, LANCASTER, KY 40444
(859) 792-1757
(859) 792-1707
Mailing address
401 DANVILLE ST, LANCASTER, KY 40444
(859) 792-1757
(859) 792-1707
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MG0230
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90009895
—
KY
Enumeration date
07/17/2006
Last updated
02/03/2010
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