1265715221 NPI number — NATIONAL MEDICAL SUPPLIERS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265715221 NPI number — NATIONAL MEDICAL SUPPLIERS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL MEDICAL SUPPLIERS LLC
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:
1265715221
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 870653
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70187-0653
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-905-9799
Provider Business Mailing Address Fax Number:
188-875-1794

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2045 N 3RD ST APT 314
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70802-5182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-906-3869
Provider Business Practice Location Address Fax Number:
888-751-7947
Provider Enumeration Date:
09/26/2011

Additional Information

Authorized Official

Authorized Official Last Name:
LYMON
Authorized Official First Name:
KAISHA
Authorized Official Middle Name:
MONIQUE
Authorized Official Title or Position:
MEMBER MANAGER
Authorized Official Telephone Number:
504-905-9799

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X , with the licence number:  000.602 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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