Provider Demographics
NPI:1447200753
Name:THRASH MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:THRASH MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:THRASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-962-3103
Mailing Address - Street 1:400 POYDRAS ST STE 1780
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-3231
Mailing Address - Country:US
Mailing Address - Phone:504-962-3103
Mailing Address - Fax:504-962-3102
Practice Address - Street 1:400 POYDRAS ST STE 1780
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3231
Practice Address - Country:US
Practice Address - Phone:504-962-3103
Practice Address - Fax:504-962-3102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA102440374332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1165271Medicaid
AL009935179Medicaid
AL009935179Medicaid