Organization
LAKESIDE HOME MEDICAL EQUIPMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLA ANN HARRIS (PRESIDENT)
(270) 866-2271
Entity
Organization
Contact information
Practice address
2418 S HIGHWAY 76, RUSSELL SPRINGS, KY 42642-8845
(270) 866-2271
Mailing address
PO BOX 587, RUSSELL SPRINGS, KY 42642-0587
(270) 866-2271
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
KY
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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