Provider Demographics
NPI:1518195890
Name:ABSOLUTE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ABSOLUTE MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:OLANIYI
Authorized Official - Middle Name:Y
Authorized Official - Last Name:OLUPONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-474-6044
Mailing Address - Street 1:124 STATE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5735
Mailing Address - Country:US
Mailing Address - Phone:337-474-6044
Mailing Address - Fax:337-474-6074
Practice Address - Street 1:124 STATE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5735
Practice Address - Country:US
Practice Address - Phone:337-474-6044
Practice Address - Fax:337-474-6074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies