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General NPI Number Information
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NPI Number | 1164633772
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Entity Type | Organization
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Legal Business Name | ASSURED MEDICAL,INC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 620 BAYOU TORTUE RD STE B1
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City | BROUSSARD
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State | LA
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Zip | 70518-7506
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Country | US
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Telephone | 337-837-7776
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82207
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City | LAFAYETTE
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State | LA
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Zip | 70598-2207
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Country | US
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Telephone | 337-837-7776
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Fax |
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Authorized Official
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Title or Position | AREA MANAGER
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Name | MR. THOMAS L EWING
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Credential |
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Telephone | 337-837-7776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 173469
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License Number State | LA
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