MEDICARE: GOLDEN MEDICAL EQUIPMENT&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

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

General Provider Information

NPI Number	:	1447218680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN MEDICAL EQUIPMENT&SUPPLY, INC.

Provider Business Mailing Address
First Line	:	2708 WOODDALE BLVD
Second Line	:	SUITEA, ROOM1
City	:	BATON ROUGE
State	:	LA
Zip	:	70805-7541
Country	:	US
Telephone Number	:	225-925-2733
Fax Number	:	225-925-2734

Provider Business Practice Location Address
First Line	:	2708 WOODDALE BLVD
Second Line	:	SUITEA, ROOM1
City	:	BATON ROUGE
State	:	LA
Zip	:	70805-7541
Country	:	US
Telephone Number	:	225-925-2733
Fax Number	:	225-925-2734

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MRS. IMEH A EBERE
Credential	:
Telephone Number	:	225-925-2733

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/22/2020

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