MEDICARE: FAIRBURN MEDICAL PRODUCTS, LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DME001035	OTHER	LA	LOUISIANA BOARD OF PHARMACY REGISTRATION
2	3011895773	OTHER		FDA REGISTRATION

General Provider Information

NPI Number	:	1275181331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRBURN MEDICAL PRODUCTS, LLC

Provider Business Mailing Address
First Line	:	5681 AL HIGHWAY 69 S
Second Line	:
City	:	CULLMAN
State	:	AL
Zip	:	35057-4225
Country	:	US
Telephone Number	:	855-721-7233
Fax Number	:	855-721-7234

Provider Business Practice Location Address
First Line	:	9323 MAMMOTH AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70814-2632
Country	:	US
Telephone Number	:	855-721-7233
Fax Number	:	855-721-7234

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MRS. CHERIE B FAIRBURN
Credential	:
Telephone Number	:	205-356-4639

Provider Enumeration Date	:	08/30/2019
Last Update Date	:	12/30/2025

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