Provider Demographics
NPI:1255754578
Name:PHYSICIAN DME SERVICES, LLC
Entity type:Organization
Organization Name:PHYSICIAN DME SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-495-9592
Mailing Address - Street 1:1011 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 37
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3243
Mailing Address - Country:US
Mailing Address - Phone:504-495-9592
Mailing Address - Fax:
Practice Address - Street 1:1011 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 37
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3243
Practice Address - Country:US
Practice Address - Phone:504-495-9592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies