Lanes-DME, Inc.
Organization Active NPI Oxygen Equipment & Supplies (DME) · Colquitt, GA
NPI 1306017223 · NPPES record last updated Aug 30, 2019
Key facts
- NPI
- 1306017223
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Oxygen Equipment & Supplies (DME) 332BX2000X
- Legal business name
- LANES-DME, INC.
- Practice address
- 210 W Main St Ste 3
Colquitt, GA 39837-3434 - Phone
- (229) 758-9111
- Fax
- (229) 758-9000
- NPI assigned
- Mar 19, 2008
- Organization subpart
- No
Authorized official
- Name
- Richard Blake Womble
- Title
- Ceo
- Phone
- (229) 758-9111
Corporate family (same tax ID) 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930066167 | GA | DME Supplier - Medical Supply Company With Respiratory Therapist |
3072634567 | Practice locations: Colquitt, GA |
National Provider Directory
- Tax ID family
- Lane'S Pharmacy DME Inc
Locations
207 W Main St
Ste B
Colquitt, GA 39837
Phone (229) 758-9111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oxygen Equipment & Supplies (DME) | 332BX2000X | Yes |
Addresses
Primary practice location
210 W Main St Ste 3
Colquitt, GA 39837-3434
Mailing address
210 W Main St Ste 3
Colquitt, GA 39837-3434
Phone (229) 758-9111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 801046279A | Medicaid | GA | |
| 801046279B | Medicaid | GA |
Other names
- LANES MEDICAL SHOPPE
Other providers in Colquitt, GA
- Edgar Lowell Justice
- Robert Marvin Kikel
- Virginia Kirkland
- Robert Anson Lane
- Lane'S Pharmacy & DME Inc
- Loving Care Personal Care Home
- Brent Martin
- Donna L McCann
- Stephanie Cook McLain
- Miller Adult Day Health
All providers in Colquitt, GA · Oxygen Equipment & Supplies (DME) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.