Organization
BURKESVILLE MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY LYNN WHITE (OWNER CEO)
(270) 864-2230
Entity
Organization
Contact information
Practice address
365 KEEN ST, BURKESVILLE, KY 42717-0006
(270) 864-2230
(270) 864-2691
Mailing address
PO BOX 6, BURKESVILLE, KY 42717-0006
(270) 864-2230
(270) 864-2691
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MG0187
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000070347
ANTHEM BC/BS
KY
01
—
006895400
BLACK LUNG
KY
01
—
45906005
ESPDT
KY
05
—
7100164320
—
KY
01
—
7100165970
ESDPT
KY
05
—
90040296
—
KY
Enumeration date
08/30/2006
Last updated
12/27/2022
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