Provider Demographics
NPI:1689729345
Name:L & B LABORATORIES, INC.
Entity Type:Organization
Organization Name:L & B LABORATORIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:BCO
Authorized Official - Phone:954-561-9513
Mailing Address - Street 1:1010 COMMON ST
Mailing Address - Street 2:SUITE 2010
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2401
Mailing Address - Country:US
Mailing Address - Phone:954-561-9513
Mailing Address - Fax:205-608-0166
Practice Address - Street 1:3403 POWERLINE RD
Practice Address - Street 2:SUITE 806
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-5935
Practice Address - Country:US
Practice Address - Phone:954-561-9513
Practice Address - Fax:205-608-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0440550001Medicare NSC