Provider Demographics
NPI:1093794273
Name:MINDEN HOMECARE EQUIPMENT & UNIFORMS
Entity Type:Organization
Organization Name:MINDEN HOMECARE EQUIPMENT & UNIFORMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISH
Authorized Official - Suffix:
Authorized Official - Credentials:CRTT
Authorized Official - Phone:318-382-8500
Mailing Address - Street 1:106 RYANS WAY
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-4230
Mailing Address - Country:US
Mailing Address - Phone:318-382-8500
Mailing Address - Fax:318-382-9010
Practice Address - Street 1:106 RYANS WAY
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-4230
Practice Address - Country:US
Practice Address - Phone:318-382-8500
Practice Address - Fax:318-382-9010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06-0113638332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1546500Medicaid
LAF1162OtherBLUE CROSS OF LA
LA1246790001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER