MLS 1116 Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MLS 1116 INC

Practice address

702 Columbia Hwy
Greensburg, KY 42743-1118

Phone

(270) 973-5276

Fax

(270) 973-5267

NPI assigned

Jul 3, 2006

Organization subpart

No

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

Authorized official

Name

Sammy Blakeman Jr.

Title

Owner Manager

Phone

(270) 634-0534

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1922038561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 COLUMBIA HWY",
            "city": "GREENSBURG",
            "state": "KY",
            "postal_code": "427431118",
            "telephone_number": "270-973-5276",
            "fax_number": "270-973-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 COLUMBIA HWY",
            "city": "GREENSBURG",
            "state": "KY",
            "postal_code": "427431118",
            "telephone_number": "270-973-5276",
            "fax_number": "270-973-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLS 1116 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "BLAKEMAN",
        "authorized_official_first_name": "SAMMY",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "270-634-0534",
        "authorized_official_name_suffix": "Jr."
    },
    "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": "90004037",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth McCreary, PHARM.D, R.PH
• Elizabeth N McCubbin, APRN
• Amanda McIlvoy
• Shelia McKinley
• Lora L Meadows-Keltner, LPCC
• Adil M Mohiuddin, M.D.
• Debrah Moon
• Rodney Taylor Moore
• Brittany Lashae Morgan Judd, LMT
• Dana N Neat, LPCC

• Durable Medical Equipment & Medical Supplies in Greensburg, KY
• Providers in Greensburg, KY by specialty
• Durable Medical Equipment & Medical Supplies in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.