Provider Demographics
NPI:1851488258
Name:HOME MEDICAL EQUIPMENT 2000 - OPELOUSAS
Entity Type:Organization
Organization Name:HOME MEDICAL EQUIPMENT 2000 - OPELOUSAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-562-1140
Mailing Address - Street 1:1901 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8915
Mailing Address - Country:US
Mailing Address - Phone:337-562-1140
Mailing Address - Fax:337-562-1142
Practice Address - Street 1:1119 PRUDHOMME CIR
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6544
Practice Address - Country:US
Practice Address - Phone:337-594-8336
Practice Address - Fax:337-594-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04-06228332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1555720Medicaid
LA1126170002Medicare NSC