Omega Medical Supply Co. LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OMEGA MEDICAL SUPPLY CO. LLC

Practice address

1970 Florida Blvd
Suite C
Denham Springs, LA 70726-4948

Phone

(225) 667-9669

Fax

(225) 667-9636

NPI assigned

Mar 9, 2007

Last updated

Mar 3, 2008By 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

Mrs. Joyce Marie Wilson

Title

Ceo

Phone

(225) 667-9669

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1679604557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 FLORIDA AVE SW",
            "address_2": "SUITE C",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707264948",
            "telephone_number": "225-667-9669",
            "fax_number": "225-667-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 FLORIDA BLVD",
            "address_2": "SUITE C",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707264948",
            "telephone_number": "225-667-9669",
            "fax_number": "225-667-9636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA MEDICAL SUPPLY CO. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-667-9669",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029963",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679604557",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Denham Springs, LA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.