Provider Demographics
NPI:1376870360
Name:EHS CORP.
Entity Type:Organization
Organization Name:EHS CORP.
Other - Org Name:SOUTHEAST MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOFIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-733-6833
Mailing Address - Street 1:1501 RIVER OAKS RD W
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-2162
Mailing Address - Country:US
Mailing Address - Phone:504-733-6833
Mailing Address - Fax:
Practice Address - Street 1:1501 RIVER OAKS RD W
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-2162
Practice Address - Country:US
Practice Address - Phone:504-733-6833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2101404Medicaid
LA6353120001Medicare NSC