Healthcare Provider Details

I. General information

NPI: 1033932173
Provider Name (Legal Business Name): INNOVATIVE HEALTHCARE PRODUCTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 W MARTIAL AVE
LAFAYETTE LA
70508-6583
US

IV. Provider business mailing address

PO BOX 82510
LAFAYETTE LA
70598-2510
US

V. Phone/Fax

Practice location:
  • Phone: 337-234-5344
  • Fax: 337-267-3293
Mailing address:
  • Phone: 337-234-5344
  • Fax: 337-267-3293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: ILYAS MUNSHI
Title or Position: OWNER
Credential: MD
Phone: 337-234-5344