Provider Demographics
NPI:1952327488
Name:DME DIRECT LLC
Entity Type:Organization
Organization Name:DME DIRECT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:ROUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-288-3799
Mailing Address - Street 1:105 HARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1101
Mailing Address - Country:US
Mailing Address - Phone:504-288-3799
Mailing Address - Fax:504-288-3752
Practice Address - Street 1:105 HARBOR CIR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1101
Practice Address - Country:US
Practice Address - Phone:504-288-3799
Practice Address - Fax:504-288-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
LA36-0010911332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG0702OtherBCBS OF LA PROVIDER ID
LA1100676Medicaid
LA1100676Medicaid