Active NPI
Healthcare Warehouse LLC
- Durable Medical Equipment & Medical Supplies
- West Monroe, LA
National Provider Identifier
1023054871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010764101 | Medicaid | TX | |
| 1685194 | Medicaid | LA | |
| 016595301 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930068176 | LA | DME Supplier - Medical Supply Company | 5193845089 | Practice locations: West Monroe, LA |
National Provider Directory
National Provider Directory- Tax ID family
- Healthcare Warehouse LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- West Monroe, LA
- NPI 1497608475
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.
-
- Durable Medical Equipment & Medical Supplies
- West Monroe, LA
- NPI 1497608475
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.