Provider Demographics
NPI:1811049943
Name:REHABILITATION SPECIALTY EQUIPMENT LLC
Entity type:Organization
Organization Name:REHABILITATION SPECIALTY EQUIPMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:HENRIKSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:225-281-3800
Mailing Address - Street 1:9311 BLUEBONNET BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2970
Mailing Address - Country:US
Mailing Address - Phone:225-767-2370
Mailing Address - Fax:225-767-2065
Practice Address - Street 1:9311 BLUEBONNET BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2970
Practice Address - Country:US
Practice Address - Phone:225-767-2370
Practice Address - Fax:225-767-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA8200171OtherUNITED HEALTH
360870OtherWELLCARE
LA2100947Medicaid
LA611857600OtherU.S. LABOR DEPT.
LAG0700OtherBLUE CROSS
LA4461320001Medicare NSC