Provider Demographics
NPI:1952604001
Name:ASHLEY MEDICAL OF MONROE INC.
Entity Type:Organization
Organization Name:ASHLEY MEDICAL OF MONROE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPHERD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-433-2820
Mailing Address - Street 1:3109 COMMON ST
Mailing Address - Street 2:STE 110
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8575
Mailing Address - Country:US
Mailing Address - Phone:337-433-2820
Mailing Address - Fax:337-433-2821
Practice Address - Street 1:3109 COMMON ST
Practice Address - Street 2:STE 110
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8575
Practice Address - Country:US
Practice Address - Phone:337-433-2820
Practice Address - Fax:337-433-2821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies