NPIMap

Organization Active NPI

Jeff Davis Medical Supplies, LLC

  • Durable Medical Equipment & Medical Supplies
  • Jennings, LA
National Provider Identifier
1073676714
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
4803 Issued in LA
Legal business name
JEFF DAVIS MEDICAL SUPPLIES, LLC
Practice address
1338 N Cutting Ave
Jennings, LA 70546-4202
Phone
(337) 824-3165
Fax
(337) 824-3183
NPI assigned
Dec 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Authorized official

Name
Mrs. Christel Doucet
Title
Business Office Manger
Phone
(337) 824-3165

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 4803 LA Primary
Nursing Facility Supplies (DME) 332BN1400X LA
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X LA

Addresses

Primary practice location

1338 N Cutting Ave
Jennings, LA 70546-4202

Mailing address

1338 N Cutting Ave
P.O. Box 757
Jennings, LA 70546-4202
Phone (337) 824-3165

Other identifiers 1

IdentifierTypeStateIssuer
1187241MedicaidLA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228780800000",
    "number": "1073676714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338 N CUTTING AVE",
            "address_2": "P.O. BOX 757",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464202",
            "telephone_number": "337-824-3165",
            "fax_number": "337-824-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 N CUTTING AVE",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705464202",
            "telephone_number": "337-824-3165",
            "fax_number": "337-824-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFF DAVIS MEDICAL SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-17",
        "last_updated": "2008-12-09",
        "status": "A",
        "authorized_official_last_name": "DOUCET",
        "authorized_official_first_name": "CHRISTEL",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANGER",
        "authorized_official_telephone_number": "337-824-3165",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "4803",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1187241",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.