Provider Demographics
NPI:1386911311
Name:LIFESTYLES FIRST MEDICAL EQUIPMENT AND SUPPLIES
Entity type:Organization
Organization Name:LIFESTYLES FIRST MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCENANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-271-8873
Mailing Address - Street 1:924 GAINESVILLE HWY STE 230
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-1639
Mailing Address - Country:US
Mailing Address - Phone:770-271-8873
Mailing Address - Fax:
Practice Address - Street 1:924 GAINESVILLE HWY STE 230
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-1639
Practice Address - Country:US
Practice Address - Phone:770-271-8873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies