Provider Demographics
NPI:1275545170
Name:ACADIAN MEDICAL
Entity Type:Organization
Organization Name:ACADIAN MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:EARLES
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:337-654-5738
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:337-654-5738
Mailing Address - Fax:318-838-2368
Practice Address - Street 1:1206 SHIRLEY RD
Practice Address - Street 2:
Practice Address - City:BUNKIE
Practice Address - State:LA
Practice Address - Zip Code:71322-1585
Practice Address - Country:US
Practice Address - Phone:337-654-5738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies