Provider Demographics
NPI:1760542641
Name:DELTA MEDICAL EQUIPMENT & SUPPLY, INC
Entity Type:Organization
Organization Name:DELTA MEDICAL EQUIPMENT & SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-602-0000
Mailing Address - Street 1:PO BOX 10504
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70181-0504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:551 HICKORY AVE
Practice Address - Street 2:
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-3104
Practice Address - Country:US
Practice Address - Phone:504-602-0000
Practice Address - Fax:504-734-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1679208Medicaid
0965340001Medicare ID - Type Unspecified