Provider Demographics
NPI:1659549558
Name:CARING HANDS MEDICAL STORE LLC
Entity Type:Organization
Organization Name:CARING HANDS MEDICAL STORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:FREDRICKA
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-336-4051
Mailing Address - Street 1:1810 CARTER ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-3115
Mailing Address - Country:US
Mailing Address - Phone:318-336-4051
Mailing Address - Fax:318-336-4052
Practice Address - Street 1:1810 CARTER ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3115
Practice Address - Country:US
Practice Address - Phone:318-336-4051
Practice Address - Fax:318-336-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0101-006521332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1021148Medicaid
LA=========OtherBLUE CROSS BLUE SHIELD
LA5947350001Medicare NSC