NPIMap

Organization Active NPI

Mobility Products Depot

  • Durable Medical Equipment & Medical Supplies
  • Youngsville, LA
National Provider Identifier
1891945119
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
4563805001 Issued in LA
Legal business name
MOBILITY PRODUCTS DEPOT
Practice address
510 Lafayette Street
Youngsville, LA 70592
Phone
(337) 504-2743
Fax
(337) 504-3014
NPI assigned
Sep 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Mr. Charles Wayne Landry
Title
Owner
Phone
(337) 504-2743

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 4563805001 LA Primary

Addresses

Primary practice location

510 Lafayette Street
Youngsville, LA 70592

Mailing address

PO Box 840
Youngsville, LA 70592-0840
Phone (337) 504-2743

Other identifiers 2

IdentifierTypeStateIssuer
G5891OtherLABLUE CROSS BLUE SHIELD
1187836MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Mobility Products Depot4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1891945119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705920840",
            "telephone_number": "337-504-2743",
            "fax_number": "337-504-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 LAFAYETTE STREET",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "70592",
            "telephone_number": "337-504-2743",
            "fax_number": "337-504-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITY PRODUCTS DEPOT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-504-2743",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "4563805001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G5891",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1187836",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngsville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.