Organization Active NPI

Healthcare Warehouse LLC

  • Durable Medical Equipment & Medical Supplies
  • West Monroe, LA
National Provider Identifier
1023054871
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HEALTHCARE WAREHOUSE LLC
Practice address
209 Expo Circle
Ste a
West Monroe, LA 71292
Phone
(318) 323-7773
Fax
(318) 323-8020
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Todd Brock
Title
Owner
Phone
(318) 323-7773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

209 Expo Circle
Ste a
West Monroe, LA 71292

Mailing address

209 Expo Circle
Ste a
West Monroe, LA 71292
Phone (318) 323-7773

Other identifiers 3

IdentifierTypeStateIssuer
010764101MedicaidTX
1685194MedicaidLA
016595301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930068176 LA DME Supplier - Medical Supply Company 5193845089 Practice locations: West Monroe, LA

National Provider Directory

National Provider Directory
Tax ID family
Healthcare Warehouse LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1216 N Victor II Blvd
Ste 10
Morgan City, LA 70380

209 Expo Cir
Ste A
West Monroe, LA 71292
Phone (318) 323-7773

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579824000000",
    "number": "1023054871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 EXPO CIRCLE",
            "address_2": "STE A",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "71292",
            "telephone_number": "318-323-7773",
            "fax_number": "318-323-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 EXPO CIRCLE",
            "address_2": "STE A",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "71292",
            "telephone_number": "318-323-7773",
            "fax_number": "318-323-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE WAREHOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-323-7773"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010764101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1685194",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016595301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.