Provider Demographics
NPI:1922054501
Name:ASSURED HOME MEDICAL RENTAL AND SALES INC
Entity Type:Organization
Organization Name:ASSURED HOME MEDICAL RENTAL AND SALES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:O
Authorized Official - Last Name:BRIGNAC
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:337-468-3636
Mailing Address - Street 1:1004 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-3124
Mailing Address - Country:US
Mailing Address - Phone:337-468-3722
Mailing Address - Fax:337-468-3648
Practice Address - Street 1:1004 6TH ST
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-3124
Practice Address - Country:US
Practice Address - Phone:337-468-3722
Practice Address - Fax:337-468-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4568622-001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1176729Medicaid
LA1176729Medicaid