Provider Demographics
NPI:1538307822
Name:ACCURATE DURABLE MEDICAL EQUIPMENT & MEDICAL SUPPLIES,LLC
Entity Type:Organization
Organization Name:ACCURATE DURABLE MEDICAL EQUIPMENT & MEDICAL SUPPLIES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSLAND
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:DRIVER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:504-439-1212
Mailing Address - Street 1:429 WALL BLVD
Mailing Address - Street 2:SUITE 407 1A
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7771
Mailing Address - Country:US
Mailing Address - Phone:504-391-3193
Mailing Address - Fax:504-391-3193
Practice Address - Street 1:429 WALL BLVD
Practice Address - Street 2:SUITE 407 1A
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7771
Practice Address - Country:US
Practice Address - Phone:504-391-3193
Practice Address - Fax:504-391-3193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA37183509332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1039438Medicaid
LA5831460001Medicare NSC