Northeast Louisiana Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NORTHEAST LOUISIANA MEDICAL SUPPLY, LLC

Practice address

777 N Washington St
Bastrop, LA 71220-3003

Phone

(318) 556-2831

NPI assigned

Feb 9, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Kennedy Dewayne Jones Sr.

Title

Owner/Administrator

Phone

(318) 669-4814

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1598037301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712203003",
            "telephone_number": "318-556-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712203003",
            "telephone_number": "318-556-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST LOUISIANA MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KENNEDY",
        "authorized_official_middle_name": "DEWAYNE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "318-669-4814",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.