JOHN LACKEY, INC; NPI #1609904663

Contact Information

JOHN LACKEY, INC

702 PROFESSIONAL PARK DR
SUITE102
SUMMERSVILLE, WV 26651-2018

Phone: 304-872-6433
Fax: 304-872-6562
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Eyewear Supplier	332H00000X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for JOHN LACKEY, INC

NPI Number 1609904663

LBN Legal business name JOHN LACKEY, INC

Authorized official JOHN LACKEY - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/01/2007

Last updated 11/03/2011 - About 15 years ago

Identifiers

WV	License #	736
WV	Other	1609904663	DME SUPPLIER NPI
WV	Other	00094926001	MEDICAID OPTICAL SUPPLIER NUMBER
WV	Other	0257640001	MEDICARE DME PTAN (SUPPLIER PTAN)
WV	Other	1205951605	MEDICARE GROUP PAYER NPI (MEDICAL PRACTICE)

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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JOHN LACKEY, INC

Contact Information

Specialty

Eyewear Supplier

NPI Profile & details for JOHN LACKEY, INC

Reviews for JOHN LACKEY, INC