MEDICARE: ASHLEY MEDICAL EQUIPMENT & SUPPLIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	090010826	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144229162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLEY MEDICAL EQUIPMENT & SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	1435 HAWN AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71107-6533
Country	:	US
Telephone Number	:	318-676-0881
Fax Number	:	318-676-0885

Provider Business Practice Location Address
First Line	:	1435 HAWN AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71107-6533
Country	:	US
Telephone Number	:	318-676-0881
Fax Number	:	318-676-0885

Authorized Official
Title or Position	:	VP OF OPERATIONS/OWNER
Name	:	MS. MELISSA C SHEPHERD
Credential	:	MLT ASCP
Telephone Number	:	318-676-0881

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/23/2011

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Directions to “ASHLEY MEDICAL EQUIPMENT & SUPPLIES, INC. ” Practice Location

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