Provider Demographics
NPI:1427306695
Name:DEVAN MEDICAL, LLC
Entity type:Organization
Organization Name:DEVAN MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-576-0779
Mailing Address - Street 1:370 ANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2406
Mailing Address - Country:US
Mailing Address - Phone:859-576-0779
Mailing Address - Fax:859-554-5766
Practice Address - Street 1:370 ANDOVER DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2406
Practice Address - Country:US
Practice Address - Phone:859-576-0779
Practice Address - Fax:859-554-5766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies