MEDICARE: WHEELCHAIR SPECIALTIES LLC

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
2	332BC3200X	Customized Equipment (DME)

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	14712	OTHER	LA	LA. REHABILITATION SERVIC

General Provider Information

NPI Number	:	1376549691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHEELCHAIR SPECIALTIES LLC

Provider Business Mailing Address
First Line	:	28480 S LAKE DR
Second Line	:
City	:	LACOMBE
State	:	LA
Zip	:	70445-3624
Country	:	US
Telephone Number	:	985-218-9699
Fax Number	:

Provider Business Practice Location Address
First Line	:	28480 S LAKE DR
Second Line	:
City	:	LACOMBE
State	:	LA
Zip	:	70445-3624
Country	:	US
Telephone Number	:	985-218-9699
Fax Number	:	985-218-9699

Authorized Official
Title or Position	:	MEMBER
Name	:	DANNY BURNAMAN
Credential	:	ATS
Telephone Number	:	985-218-9699

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	12/29/2016

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Directions to “WHEELCHAIR SPECIALTIES LLC ” Practice Location

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