Provider Demographics
NPI:1538196019
Name:COOLEY MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:COOLEY MEDICAL EQUIPMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-441-8876
Mailing Address - Street 1:1019 TOWN DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:KY
Mailing Address - Zip Code:41076-9114
Mailing Address - Country:US
Mailing Address - Phone:859-441-8876
Mailing Address - Fax:
Practice Address - Street 1:4201 PRODUCE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-3064
Practice Address - Country:US
Practice Address - Phone:502-459-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY8200292OtherMEDICAL SUPPLY CO W/RESPI
KY90010364Medicaid
KY000000066648OtherMEDICAL SUPPLY CO W/RESPI
KY046021500OtherMEDICAL SUPPLY CO W/RESPI
KY611194985OtherMEDICAL SUPPLY CO W/RESPI
KY04021500OtherMEDICAL SUPPLY CO W/RESPI
KY6000116OtherMEDICAL SUPPLY CO W/RESPI
VA9110232Medicaid
KY90010364Medicaid
WV0146880000Medicaid
KY0186310009Medicare NSC