Healthcare Provider Details

I. General information

NPI: 1376549691
Provider Name (Legal Business Name): WHEELCHAIR SPECIALTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28480 S LAKE DR
LACOMBE LA
70445-3624
US

IV. Provider business mailing address

28480 S LAKE DR
LACOMBE LA
70445-3624
US

V. Phone/Fax

Practice location:
  • Phone: 985-218-9699
  • Fax: 985-218-9699
Mailing address:
  • Phone: 985-218-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DANNY BURNAMAN
Title or Position: MEMBER
Credential: ATS
Phone: 985-218-9699