Healthcare Provider Details

I. General information

NPI: 1922054501
Provider Name (Legal Business Name): ASSURED HOME MEDICAL RENTAL AND SALES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 6TH ST
MAMOU LA
70554-3124
US

IV. Provider business mailing address

1004 6TH ST
MAMOU LA
70554-3124
US

V. Phone/Fax

Practice location:
  • Phone: 337-468-3722
  • Fax: 337-468-3648
Mailing address:
  • Phone: 337-468-3722
  • Fax: 337-468-3648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4568622-001
License Number StateLA

VIII. Authorized Official

Name: MARILYN O BRIGNAC
Title or Position: SECRETARY
Credential: DME
Phone: 337-468-3636