Provider Demographics
NPI:1174523203
Name:MOUNTAIN MEDICAL EQUIPMENT, INC
Entity type:Organization
Organization Name:MOUNTAIN MEDICAL EQUIPMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:KAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-588-9630
Mailing Address - Street 1:PO BOX 922189
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30010-2189
Mailing Address - Country:US
Mailing Address - Phone:866-449-4784
Mailing Address - Fax:888-835-3354
Practice Address - Street 1:2401 REGENCY RD STE 302
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2914
Practice Address - Country:US
Practice Address - Phone:866-449-4784
Practice Address - Fax:888-835-3354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90005505Medicaid
KY4632330001Medicare ID - Type Unspecified