MEDICARE: TECHE DME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1770892358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TECHE DME LLC

Provider Business Mailing Address
First Line	:	1406 NE EVANGELINE TRWY
Second Line	:	SUITE 200
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-2830
Country	:	US
Telephone Number	:	337-889-5785
Fax Number	:	337-889-5786

Provider Business Practice Location Address
First Line	:	1406 NE EVANGELINE TRWY
Second Line	:	SUITE 200
City	:	LAFAYETTE
State	:	LA
Zip	:	70501-2830
Country	:	US
Telephone Number	:	337-889-5785
Fax Number	:	337-889-5786

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MISS KRISTAL GLOVER
Credential	:	RN
Telephone Number	:	337-212-9022

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	11/21/2016

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Directions to “TECHE DME LLC ” Practice Location

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