1447207006 NPI number — AMERICAN HOME MEDICAL EQUIPMENT, INC.

Table of content: MRS. LA RHONDA TORAY WADE LVN (NPI 1346602539)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447207006 NPI number — AMERICAN HOME MEDICAL EQUIPMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HOME MEDICAL EQUIPMENT, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447207006
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6560 YOUREE DR
Provider Second Line Business Mailing Address:
SUITE 1009
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71105-4657
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-524-2463
Provider Business Mailing Address Fax Number:
318-524-2466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6560 YOUREE DR
Provider Second Line Business Practice Location Address:
SUITE 1009
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71105-4657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-524-2463
Provider Business Practice Location Address Fax Number:
318-524-2466
Provider Enumeration Date:
05/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PETERSON
Authorized Official First Name:
ALVIN
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
318-524-2463

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BX2000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1428094 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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