Provider Demographics
NPI:1336242635
Name:CLOVER DURABLE MEDICAL EQUIPMENT, LLC
Entity type:Organization
Organization Name:CLOVER DURABLE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-283-5900
Mailing Address - Street 1:6305 ELYSIAN FIELD AVE
Mailing Address - Street 2:# 206
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4245
Mailing Address - Country:US
Mailing Address - Phone:504-283-5900
Mailing Address - Fax:504-283-5229
Practice Address - Street 1:6305 ELYSIAN FIELD AVENUE
Practice Address - Street 2:# 206
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-4245
Practice Address - Country:US
Practice Address - Phone:504-283-5900
Practice Address - Fax:504-283-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5782760001Medicare NSC