Provider Demographics
NPI:1174788459
Name:LCM ENTERPRISES, INC.
Entity type:Organization
Organization Name:LCM ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MACMASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-947-5666
Mailing Address - Street 1:146 KENNEDY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5133
Mailing Address - Country:US
Mailing Address - Phone:207-873-6151
Mailing Address - Fax:
Practice Address - Street 1:146 KENNEDY DRIVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5133
Practice Address - Country:US
Practice Address - Phone:207-873-6151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LCM ENTERPRISES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-25
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME002610OtherANTHEM BC & BS
ME432819900Medicaid