Provider Demographics
NPI:1063414571
Name:JL WEBB DME LLC
Entity type:Organization
Organization Name:JL WEBB DME LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-746-5745
Mailing Address - Street 1:330 31 W BYPASS
Mailing Address - Street 2:STE 401
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101
Mailing Address - Country:US
Mailing Address - Phone:270-746-5745
Mailing Address - Fax:270-746-5747
Practice Address - Street 1:330 31 W BYPASS
Practice Address - Street 2:STE 401
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101
Practice Address - Country:US
Practice Address - Phone:270-746-5745
Practice Address - Fax:270-746-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY226929332BC3200X
KY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90003534Medicaid
TN4040075OtherBC/BS OF TENNESSEE
KY000000278195OtherBC/BS OF KENTUCKY
KY25234OtherBLUEGRASS FAMILY HEALTH
KY1160919OtherPASSPORT
KY000000278195OtherBC/BS OF KENTUCKY