MEDICARE: PATIENTS CARE MEDICAL SUPPLY, 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	332B00000X	Durable Medical Equipment & Medical Supplies		LA
2	332B00000X	Durable Medical Equipment & Medical Supplies

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	H3210	OTHER	LA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1356380760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATIENTS CARE MEDICAL SUPPLY, INC.

Provider Business Mailing Address
First Line	:	PO BOX 246
Second Line	:
City	:	MAURICE
State	:	LA
Zip	:	70555-0246
Country	:	US
Telephone Number	:	337-989-0005
Fax Number	:	337-989-0006

Provider Business Practice Location Address
First Line	:	8907 MAURICE AVE
Second Line	:	SUITE B
City	:	MAURICE
State	:	LA
Zip	:	70555-4439
Country	:	US
Telephone Number	:	337-989-0005
Fax Number	:	337-989-0006

Authorized Official
Title or Position	:	CFO
Name	:	REBECCA JONES
Credential	:
Telephone Number	:	337-989-0005

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	01/31/2024

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