Organization
LUCKY MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUCKO JEAN (GEN PTR)
(631) 741-1895
Entity
Organization
Contact information
Practice address
1580 OCEAN AVE, BOHEMIA, NY 11716-1916
(631) 741-1895
(631) 257-5866
Mailing address
1580 OCEAN AVE, BOHEMIA, NY 11716-1916
(631) 741-1895
(631) 257-5866
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321
—
NY
Enumeration date
01/03/2020
Last updated
01/03/2020
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