Organization
MARILYN'S MEDICAL FREEDOM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER M FOX (OFFICE MANAGER)
(270) 534-9713
Entity
Organization
Contact information
Practice address
4860 OLD MAYFIELD RD, PADUCAH, KY 42003-9074
(270) 534-9713
(270) 554-4643
Mailing address
4860 OLD MAYFIELD RD, PADUCAH, KY 42003-9074
(270) 534-9713
(270) 554-4643
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
KY
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000385287
ANTHEM BCBS
KY
05
—
45003878
—
KY
05
—
90012808
—
KY
Enumeration date
08/01/2006
Last updated
05/05/2008
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