Lucky Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LUCKY MEDICAL SUPPLY

Practice address

1580 Ocean Ave
Bohemia, NY 11716-1916

Phone

(631) 741-1895

Fax

(631) 257-5866

NPI assigned

Jan 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Lucko Jean

Title

Gen PTR

Phone

(631) 741-1895

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1356980627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 OCEAN AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161916",
            "telephone_number": "631-741-1895",
            "fax_number": "631-257-5866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 OCEAN AVE",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161916",
            "telephone_number": "631-741-1895",
            "fax_number": "631-257-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCKY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "LUCKO",
        "authorized_official_title_or_position": "GEN PTR",
        "authorized_official_telephone_number": "631-741-1895",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0321",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "luckyambulette@optonline.net",
            "affiliation": "N",
            "address_1": "1580 Ocean Ave",
            "city": "Bohemia",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117161916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Bohemia, NY
• Providers in Bohemia, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.