Provider Demographics
NPI:1043418080
Name:MILLENNIUM HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:MILLENNIUM HEALTH CARE SERVICES
Other - Org Name:MILLENNIUM MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAINE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:225-923-3117
Mailing Address - Street 1:701 N PIERCE ST
Mailing Address - Street 2:STE. 2
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-3529
Mailing Address - Country:US
Mailing Address - Phone:337-266-6077
Mailing Address - Fax:337-266-6083
Practice Address - Street 1:701 N PIERCE ST
Practice Address - Street 2:STE. 2
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-3529
Practice Address - Country:US
Practice Address - Phone:337-266-6077
Practice Address - Fax:337-266-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1012076Medicaid
LA6036460001Medicare NSC