Provider Demographics
NPI:1780696823
Name:DME OF LOUISIANA LLC
Entity type:Organization
Organization Name:DME OF LOUISIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DELANA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-747-2338
Mailing Address - Street 1:107 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2815
Mailing Address - Country:US
Mailing Address - Phone:985-747-2338
Mailing Address - Fax:985-747-2068
Practice Address - Street 1:107 E OAK ST
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2815
Practice Address - Country:US
Practice Address - Phone:985-747-2338
Practice Address - Fax:985-747-2068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4504973-001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5101360001Medicare ID - Type UnspecifiedREGION C