Provider Demographics
NPI:1306440763
Name:SOUTH MED DME LLC
Entity type:Organization
Organization Name:SOUTH MED DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASNAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AIJAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-800-8469
Mailing Address - Street 1:1270 STRASSNER DR UNIT 3410
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-1888
Mailing Address - Country:US
Mailing Address - Phone:504-512-2281
Mailing Address - Fax:
Practice Address - Street 1:724 LITTLE FARMS AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-5912
Practice Address - Country:US
Practice Address - Phone:504-512-2281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies