Lincoln Lakes Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LINCOLN LAKES MEDICAL SUPPLY, LLC

Practice address

150 W Broadway Ste 2
Lincoln, ME 04457-4003

Phone

(207) 403-9411

Fax

(207) 403-9415

NPI assigned

Aug 7, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Herbert Gulesian, RRT

Title

Manager

Phone

(207) 403-9411

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1922587427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 WEST BROADWAY SUITE 2",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "04457",
            "telephone_number": "207-794-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W BROADWAY STE 2",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574003",
            "telephone_number": "207-403-9411",
            "fax_number": "207-403-9415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN LAKES MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "GULESIAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "HERBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "207-403-9411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Durwin Yang Libby, DMD
• Kenneth B Liberty, PH.D.
• Susan Ruth Lifer, PT
• Limitless Therapy & Wellness PLLC
• Lincoln Dental, PLLC
• Lincoln Smiles Dentistry, LLC
• Lauri Ann Lockhart, LCSW
• Brooke Birmingham Loring, CADC, LCPC
• Betty Macdonald
• Ashlee Maddonald, RDH

• All providers in Lincoln, ME
• Durable Medical Equipment & Medical Supplies in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.