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General NPI Number Information
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NPI Number | 1760988273
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Entity Type | Organization
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Legal Business Name | ESSENTIAL MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 04/03/2018
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Last Update Date | 04/03/2018
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Provider Practice Location Address
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Address Line | 3605 MCVEA STREET
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City | BAKER
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State | LA
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Zip | 70714-3518
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Country | US
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Telephone | 225-681-3551
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Fax |
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Provider Business Mailing Address
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Address Line | 3605 MCVEA STREET
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City | BAKER
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State | LA
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Zip | 70714-3518
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Country | US
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Telephone | 225-681-3551
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Fax |
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Authorized Official
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Title or Position | HEALTHCARE ADMINISTRATOR
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Name | MS. KARAH DANIELLE MARTIN
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Credential |
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Telephone | 225-349-9366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | LA
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