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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