Provider Demographics
NPI:1083779862
Name:TRIPLE STAR MEDICAL SUPPLIES L.L.C.
Entity Type:Organization
Organization Name:TRIPLE STAR MEDICAL SUPPLIES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHITURU
Authorized Official - Middle Name:AKOMA
Authorized Official - Last Name:NWOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-298-3313
Mailing Address - Street 1:11766 S HARRELLS FERRY RD
Mailing Address - Street 2:SUITE 'C'
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-5304
Mailing Address - Country:US
Mailing Address - Phone:225-298-3313
Mailing Address - Fax:
Practice Address - Street 1:11766 S HARRELLS FERRY RD
Practice Address - Street 2:SUITE 'C'
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-5304
Practice Address - Country:US
Practice Address - Phone:225-298-3313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5848050001Medicare NSC