Provider Demographics
NPI:1669662631
Name:TROMAR DME SUPPLIES, LLC
Entity type:Organization
Organization Name:TROMAR DME SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:OTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-878-9228
Mailing Address - Street 1:PO BOX 1356
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:70443-1356
Mailing Address - Country:US
Mailing Address - Phone:985-878-9228
Mailing Address - Fax:
Practice Address - Street 1:312 WEST 4TH STREET
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:LA
Practice Address - Zip Code:70443
Practice Address - Country:US
Practice Address - Phone:985-878-9228
Practice Address - Fax:985-878-9212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5388970-001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1015954Medicaid
LA1015954Medicaid