Provider Demographics
NPI:1679567168
Name:LANE'S PHARMACY & DME INC
Entity type:Organization
Organization Name:LANE'S PHARMACY & DME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-758-9111
Mailing Address - Street 1:210 W MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:COLQUITT
Mailing Address - State:GA
Mailing Address - Zip Code:39837-3433
Mailing Address - Country:US
Mailing Address - Phone:229-758-9111
Mailing Address - Fax:229-758-9000
Practice Address - Street 1:210 W MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:COLQUITT
Practice Address - State:GA
Practice Address - Zip Code:39837-3433
Practice Address - Country:US
Practice Address - Phone:229-758-9111
Practice Address - Fax:229-758-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-10
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition