Healthcare Provider Details

I. General information

NPI: 1194817205
Provider Name (Legal Business Name): ACADIAN MEDICAL SUPPLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 CHEVY LN SUITE C
BUNKIE LA
71322-1561
US

IV. Provider business mailing address

PO BOX 700
BUNKIE LA
71322-0700
US

V. Phone/Fax

Practice location:
  • Phone: 318-346-1560
  • Fax: 318-346-1562
Mailing address:
  • Phone: 318-346-1560
  • Fax: 318-346-1562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: AMY LEMOINE MAYEUX
Title or Position: OWNER
Credential:
Phone: 318-346-1560