Healthcare Provider Details

I. General information

NPI: 1760542641
Provider Name (Legal Business Name): DELTA MEDICAL EQUIPMENT & SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 HICKORY AVE
HARAHAN LA
70123-3104
US

IV. Provider business mailing address

PO BOX 10504
NEW ORLEANS LA
70181-0504
US

V. Phone/Fax

Practice location:
  • Phone: 504-602-0000
  • Fax: 504-734-1293
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK W LOBELL
Title or Position: PRESIDENT
Credential:
Phone: 504-602-0000