Individual
LENDON L ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 VAUGHN DR, LUCEDALE, MS 39452-3316
(601) 947-0032
Mailing address
PO BOX 914, LUCEDALE, MS 39452-0914
(601) 947-0032
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
RCP0779
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440097
—
MS
Enumeration date
03/17/2008
Last updated
06/02/2008
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