Provider Demographics
NPI:1497094593
Name:SYMMETRX MEDICAL LLC
Entity Type:Organization
Organization Name:SYMMETRX MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BLANCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-802-3062
Mailing Address - Street 1:9433 COUNTRY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-7028
Mailing Address - Country:US
Mailing Address - Phone:337-802-3062
Mailing Address - Fax:888-481-0847
Practice Address - Street 1:9433 COUNTRY LAKE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-7028
Practice Address - Country:US
Practice Address - Phone:337-802-3062
Practice Address - Fax:888-481-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site