MEDICARE: THRASH MEDICAL SUPPLY, 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	131986	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851571731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRASH MEDICAL SUPPLY, LLC

Provider Business Mailing Address
First Line	:	1010 COMMON ST
Second Line	:	SUITE 2660
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2401
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 COMMON ST
Second Line	:	SUITE 2660
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2401
Country	:	US
Telephone Number	:	504-962-3103
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. SANDRA D. THRASH
Credential	:
Telephone Number	:	504-962-3103

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	11/08/2007

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Directions to “THRASH MEDICAL SUPPLY, LLC ” Practice Location

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