Healthcare Provider Details

I. General information

NPI: 1952327488
Provider Name (Legal Business Name): DME DIRECT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 12/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HARBOR CIR
NEW ORLEANS LA
70126-1101
US

IV. Provider business mailing address

105 HARBOR CIR
NEW ORLEANS LA
70126-1101
US

V. Phone/Fax

Practice location:
  • Phone: 504-288-3799
  • Fax: 504-288-3752
Mailing address:
  • Phone: 504-288-3799
  • Fax: 504-288-3752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number36-0010911
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number36-0010911
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE HASSAN ROUSSELL
Title or Position: VICE-PRESIDENT
Credential:
Phone: 504-288-3799