MEDICARE: ULTRA MEDICAL EQUIPMENT 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

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	:	1629181664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTRA MEDICAL EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	3600 GENERAL MEYER AVE
Second Line	:	SUITE D
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-3393
Country	:	US
Telephone Number	:	504-361-8378
Fax Number	:	504-361-8379

Provider Business Practice Location Address
First Line	:	3600 GENERAL MEYER AVE
Second Line	:	SUITE D
City	:	NEW ORLEANS
State	:	LA
Zip	:	70114-3393
Country	:	US
Telephone Number	:	504-361-8378
Fax Number	:	504-361-8379

Authorized Official
Title or Position	:	CO OWNER
Name	:	MS. DESHIRAE NICOLE OWENS
Credential	:
Telephone Number	:	504-361-8378

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	12/22/2007

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Directions to “ULTRA MEDICAL EQUIPMENT LLC ” Practice Location

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