Provider Demographics
NPI:1194817205
Name:ACADIAN MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:ACADIAN MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LEMOINE
Authorized Official - Last Name:MAYEUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-346-1560
Mailing Address - Street 1:PO BOX 700
Mailing Address - Street 2:
Mailing Address - City:BUNKIE
Mailing Address - State:LA
Mailing Address - Zip Code:71322-0700
Mailing Address - Country:US
Mailing Address - Phone:318-346-1560
Mailing Address - Fax:318-346-1562
Practice Address - Street 1:109 CHEVY LN
Practice Address - Street 2:SUITE C
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1561
Practice Address - Country:US
Practice Address - Phone:318-346-1560
Practice Address - Fax:318-346-1562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1463019Medicaid
LA5232370001Medicare ID - Type Unspecified