NPIMap

Organization Active NPI

Redstick Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Gonzales, LA
National Provider Identifier
1699841858
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
G02124 Issued in LA
Legal business name
REDSTICK MEDICAL SUPPLY
Practice address
1818 E Evergreen St
Gonzales, LA 70737-4911
Phone
(225) 715-5790
Fax
(225) 644-5572
NPI assigned
Nov 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Dami Lyn Minvielle, CLS
Title
Owner
Phone
(225) 715-5790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X G02124 LA Primary

Addresses

Primary practice location

1818 E Evergreen St
Gonzales, LA 70737-4911

Mailing address

1818 E Evergreen St
Gonzales, LA 70737-4911
Phone (225) 715-5790

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699841858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 E EVERGREEN ST",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374911",
            "telephone_number": "225-715-5790",
            "fax_number": "225-644-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 E EVERGREEN ST",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374911",
            "telephone_number": "225-715-5790",
            "fax_number": "225-644-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDSTICK MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MINVIELLE",
        "authorized_official_first_name": "DAMI",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-715-5790",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CLS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "G02124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.