Provider Demographics
NPI:1013070945
Name:DUDLEY ENTERPRISES
Entity Type:Organization
Organization Name:DUDLEY ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ZELL
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-459-1440
Mailing Address - Street 1:PO BOX 13524
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315-3524
Mailing Address - Country:US
Mailing Address - Phone:800-815-0586
Mailing Address - Fax:318-445-9433
Practice Address - Street 1:2521 SAMFORD AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71103-3727
Practice Address - Country:US
Practice Address - Phone:318-459-1440
Practice Address - Fax:318-459-1439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1259930001OtherNSC NUMBER