Organization
LIFETIME MEDICAL SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK GELSTHORPE (PRESIDENT)
(815) 672-0670
Entity
Organization
Contact information
Practice address
1215 N OTTERCREEK RD., STREATOR, IL 61364
(815) 672-0670
Mailing address
1215 N OTTERCREEK RD., STREATOR, IL 61364
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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