=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235308610
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUDUBON SURGICAL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/29/2008
-----------------------------------------------------
Last Update Date | 02/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 117 CLEARVIEW PKWY
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-4618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-864-8033
-----------------------------------------------------
Fax | 550-486-4803
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 117 CLEARVIEW PKWY
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70001-4618
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-864-8033
-----------------------------------------------------
Fax | 550-486-4803
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SEAN KANE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 504-864-8033
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------