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Organization

CENTRAL KENTUCKY MOBILITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID PRESTON ATP (PRESIDENT)
(895) 255-3624
Entity
Organization

Contact information

Practice address
1050 ENTERPRISE DR, STE 125, LEXINGTON, KY 40510-1016
(859) 255-3624
Mailing address
1050 ENTERPRISE DR, STE 125, LEXINGTON, KY 40510-1014
(859) 255-3624

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
247648
KY
332BC3200X
Customized Equipment (DME)
Primary
247648
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000295533
ANTHEM FACETS
KY
05
45001658
KY
05
90005653
KY
Enumeration date
08/28/2006
Last updated
09/28/2009
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