Healthcare Provider Details

I. General information

NPI: 1093794273
Provider Name (Legal Business Name): MINDEN HOMECARE EQUIPMENT & UNIFORMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 04/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 RYANS WAY
MINDEN LA
71055-4230
US

IV. Provider business mailing address

106 RYANS WAY
MINDEN LA
71055-4230
US

V. Phone/Fax

Practice location:
  • Phone: 318-382-8500
  • Fax: 318-382-9010
Mailing address:
  • Phone: 318-382-8500
  • Fax: 318-382-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number06-0113638
License Number StateLA

VIII. Authorized Official

Name: ROBN FISH
Title or Position: OWNER
Credential: CRTT
Phone: 318-382-8500