Healthcare Provider Details

I. General information

NPI: 1376773515
Provider Name (Legal Business Name): LEEMCO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E PINHOOK RD
LAFAYETTE LA
70501-8534
US

IV. Provider business mailing address

224 E PINHOOK RD
LAFAYETTE LA
70501-8534
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-3004
  • Fax: 337-289-6600
Mailing address:
  • Phone: 337-289-3004
  • Fax: 337-289-6600

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 TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. LEE CARRICUT
Title or Position: PRESIDENT
Credential:
Phone: 337-289-3004