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NPI Code Detail

MEDICARE: MESHELLS HOME RESPIRATORY MEDS LLC

MEDICARE: MESHELLS HOME RESPIRATORY MEDS 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
1333600000XPharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1331931585XOTHERLABCBSL PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548242175
Entity Type Code : Organization
Provider Name (Legal Business Name) : MESHELLS HOME RESPIRATORY MEDS LLC
Provider Business Mailing Address
First Line : 2880 N HIGHWAY 171
Second Line : SUITE B
City : LAKE CHARLES
State : LA
Zip : 70611-4330
Country : US
Telephone Number : 337-217-1308
Fax Number : 337-217-1235
Provider Business Practice Location Address
First Line : 2880 N HIGHWAY 171
Second Line : SUITE B
City : LAKE CHARLES
State : LA
Zip : 70611-4330
Country : US
Telephone Number : 337-217-1308
Fax Number : 337-217-1235
Authorized Official
Title or Position : OWNER
Name : MICHELLE G FAWCETT
Credential :
Telephone Number : 337-217-1308
Provider Enumeration Date : 11/18/2005
Last Update Date : 07/08/2008

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