Meridian Medical Supply LLC

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

35-0012400 Issued in LA

Legal business name

MERIDIAN MEDICAL SUPPLY LLC

Practice address

1029 Keyser Ave
Suite M2
Natchitoches, LA 71457-6239

Phone

(318) 238-7350

Fax

(318) 238-7351

NPI assigned

Nov 2, 2010

Last updated

Nov 2, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Willie Jack Corley Sr., M.D.

Title

Operations Manager

Phone

(318) 256-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1669772927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 KEYSER AVE",
            "address_2": "SUITE M2",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576239",
            "telephone_number": "318-238-7350",
            "fax_number": "318-238-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 KEYSER AVE",
            "address_2": "SUITE M2",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576239",
            "telephone_number": "318-238-7350",
            "fax_number": "318-238-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "CORLEY",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "318-256-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "LA",
            "license": "35-0012400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356182",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Natchitoches, LA by specialty
• Oxygen Equipment & Supplies (DME) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; 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.