Provider Demographics
NPI:1710957758
Name:LOUISIANA MEDICAL SUPPLY. INC.
Entity Type:Organization
Organization Name:LOUISIANA MEDICAL SUPPLY. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLLEMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:337-369-6000
Mailing Address - Street 1:PO BOX 10226
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70562-0226
Mailing Address - Country:US
Mailing Address - Phone:337-369-6000
Mailing Address - Fax:337-369-6024
Practice Address - Street 1:1986 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560
Practice Address - Country:US
Practice Address - Phone:337-369-6000
Practice Address - Fax:337-369-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAB2977OtherBLUE CROSS BLUE SHIELD
LA1958433Medicaid
LA0782510001Medicare NSC