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Organization

LINCOLN MEDICAL SUPPLY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MOHAMMED Q SAJID (PRESIDENT)
(270) 769-0317
Entity
Organization

Contact information

Practice address
1815 N DIXIE HWY, SUITE 1, ELIZABETHTOWN, KY 42701-9424
(270) 769-0317
(270) 769-0318
Mailing address
1815 N DIXIE AVE STE 103, ELIZABETHTOWN, KY 42701-9424
(270) 769-0317
(270) 769-0318

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
268229
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000505127
ANTHEM
KY
01
2812641000
PASSPORT ADVANTAGE
KY
01
50013434
PASSPORT
KY
01
612251300
BLACK LUNG
KY
05
90013954
KY
Enumeration date
09/21/2006
Last updated
07/08/2022
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