Provider Demographics
NPI:1548282395
Name:MED-AIR, LLC.
Entity type:Organization
Organization Name:MED-AIR, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MELANCON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:337-332-5811
Mailing Address - Street 1:138 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-5114
Mailing Address - Country:US
Mailing Address - Phone:337-332-5811
Mailing Address - Fax:337-332-6101
Practice Address - Street 1:138 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-5114
Practice Address - Country:US
Practice Address - Phone:337-332-5811
Practice Address - Fax:337-332-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA500011430332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1527548Medicaid
LA4532690001Medicare ID - Type Unspecified