MEDICARE: FACTOR- A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1083236053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FACTOR- A

Provider Business Mailing Address
First Line	:	PO BOX 81734
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70598-1734
Country	:	US
Telephone Number	:	337-534-0248
Fax Number	:	337-806-9642

Provider Business Practice Location Address
First Line	:	1200 CAMELLIA BLVD STE 400
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6163
Country	:	US
Telephone Number	:	337-534-0248
Fax Number	:	337-806-9642

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AHMAD ELAKIL
Credential	:	MD, MBA
Telephone Number	:	337-534-0248

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	05/13/2020

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Directions to “FACTOR- A ” Practice Location

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