Provider Demographics
NPI:1801207048
Name:SOUTHEAST DME
Entity type:Organization
Organization Name:SOUTHEAST DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMIDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM
Authorized Official - Phone:504-333-6071
Mailing Address - Street 1:5745 PLAUCHE CT
Mailing Address - Street 2:STE B
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5745 PLAUCHE CT
Practice Address - Street 2:STE B
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-4119
Practice Address - Country:US
Practice Address - Phone:504-333-6071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-09
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based