Provider Demographics
NPI:1851320741
Name:PSALMS 23 DME
Entity Type:Organization
Organization Name:PSALMS 23 DME
Other - Org Name:PSALMS 23 DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:RICHARDSON
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-228-6160
Mailing Address - Street 1:3351 KABEL DR
Mailing Address - Street 2:SUITE H
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-6990
Mailing Address - Country:US
Mailing Address - Phone:504-392-5811
Mailing Address - Fax:504-392-5642
Practice Address - Street 1:3351 KABEL DR
Practice Address - Street 2:SUITE H
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-6990
Practice Address - Country:US
Practice Address - Phone:504-392-5811
Practice Address - Fax:504-392-5642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1199589332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1179221Medicaid
LA1179221Medicaid