Organization
MEDICOM, INC.
Active
Other names
LYON HOME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENNY EARL THOMAS D.O. (SECRETARY)
(573) 774-6279
Entity
Organization
Contact information
Practice address
215 NORTH ST, SUITE A, WAYNESVILLE, MO 65583-2553
(573) 774-8488
(573) 774-6806
Mailing address
215 NORTH ST, SUITE A, WAYNESVILLE, MO 65583-2553
(573) 774-8488
(573) 774-6806
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
900708
MO
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
900708
MO
335E00000X
Prosthetic/Orthotic Supplier
900708
MO
Other
Enumeration date
05/15/2007
Last updated
09/11/2025
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