Provider Demographics
NPI:1821498106
Name:AXUM MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:AXUM MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:LUCIEN
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:504-390-2564
Mailing Address - Street 1:501 INDIGO PKWY
Mailing Address - Street 2:UNIT 37
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-2200
Mailing Address - Country:US
Mailing Address - Phone:504-390-2564
Mailing Address - Fax:985-651-0190
Practice Address - Street 1:501 INDIGO PKWY
Practice Address - Street 2:UNIT 37
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-2200
Practice Address - Country:US
Practice Address - Phone:504-390-2564
Practice Address - Fax:985-651-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-24
Last Update Date:2014-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies