Provider Demographics
NPI:1235176777
Name:ALLSTAR MEDICA SUPPLIES
Entity Type:Organization
Organization Name:ALLSTAR MEDICA SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AHAOMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:OHIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA 2ND ED
Authorized Official - Phone:225-924-7080
Mailing Address - Street 1:1821 WOODDALE CT
Mailing Address - Street 2:STE 210
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-924-7080
Mailing Address - Fax:225-923-3528
Practice Address - Street 1:1821 WOODDALE CT
Practice Address - Street 2:STE 210
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-924-7080
Practice Address - Fax:225-923-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4864310002Medicare ID - Type Unspecified