NORTHEAST LOUISIANA MEDICAL SUPPLY, LLC (NPI# 1598037301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598037301 |
| Entity Type | Organization |
| Organization Name | NORTHEAST LOUISIANA MEDICAL SUPPLY, LLC |
| Practice Address |
777 N Washington St Bastrop LA 71220-3003 |
| Practice Telephone | 3185562831 |
| Mailing Telephone | 3185562831 |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |
| Authorized Official Name | MR. KENNEDY DEWAYNE JONES SR. (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 3186694814 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers | ||
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
777 N WASHINGTON ST |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-3003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952935983 | Broken Wings Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2869 New Monroe Road, Bastrop, LA 71220 | 2020-02-28 |
| 1275002685 | Hulin Urgent Care Services, LLC | Clinic/Center | 2100 East Madison Avenue, Bastrop, LA 71220 | 2018-11-14 |
| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1538609524 | Tyrra Watkins | Counselor | 10599 Parkwood Dr, Bastrop, LA 71220 | 2017-02-24 |
| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
| Find all providers in zip 71220 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275853236 | Heavenly Medical Supply,llc | Durable Medical Equipment & Medical Supplies | 6349 Estates Dr., Bastrop, NONE NONE | 2010-06-01 |
| 1669790929 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1671 Highway 71 E, Bastrop, TX 78602-4314 | 2010-05-12 |
| 1255598231 | Harris Personal Care LLC | Durable Medical Equipment & Medical Supplies | 148 S Liberty St, Bastrop, LA 71220-4623 | 2008-05-19 |
| 1215114731 | Central Texas Pain Institute,pllc | Durable Medical Equipment & Medical Supplies | 3101 Highway 71 E Ste 211, Bastrop, TX 78602-5156 | 2008-01-28 |
| 1710099668 | Morehouse Pharmaceutical Co Inc | Durable Medical Equipment & Medical Supplies | 123 W Madison Ave, Bastrop, LA 71220-3702 | 2006-08-31 |
| 1114036514 | K & B Louisiana Corporation | Durable Medical Equipment & Medical Supplies | 727 North Washington Street, Bastrop, LA 71220-3003 | 2006-08-30 |
| 1255346342 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 504 W State Highway 71, Bastrop, TX 78602-3735 | 2006-07-29 |
| 1518984871 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 6091 Hwy 165, Bastrop, LA 71220 | 2006-07-16 |
| 1538124953 | Fayette Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 123 Old Austin Hwy, Bastrop, TX 78602-5128 | 2006-04-19 |
| 1902271935 | Central Texas Pain Institute, Pllc | Durable Medical Equipment & Medical Supplies | 3101 Highway 71 E, Suite 211, Bastrop, TX 78602-5156 | 2015-12-02 |
| Find all providers in BASTROP | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.