Provider Demographics
NPI:1659418424
Name:CARMICHAEL'S NUTRITIONAL DISTRIBUTOR, INC.
Entity Type:Organization
Organization Name:CARMICHAEL'S NUTRITIONAL DISTRIBUTOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:D
Authorized Official - Last Name:FINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-783-7200
Mailing Address - Street 1:1002 N PARKERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3613
Mailing Address - Country:US
Mailing Address - Phone:337-783-7263
Mailing Address - Fax:337-783-8996
Practice Address - Street 1:1002 N PARKERSON AVE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-3613
Practice Address - Country:US
Practice Address - Phone:337-783-7263
Practice Address - Fax:337-783-8996
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARMICHAEL'S CASHWAY PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-31
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies