Provider Demographics
NPI:1588862213
Name:ACADIAN MEDICAL EQUIPMENT & SUPPLY LLC
Entity type:Organization
Organization Name:ACADIAN MEDICAL EQUIPMENT & SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:RABALAIS
Authorized Official - Last Name:LANDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-687-7195
Mailing Address - Street 1:PO BOX 829
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70765-0829
Mailing Address - Country:US
Mailing Address - Phone:225-687-7195
Mailing Address - Fax:225-752-0068
Practice Address - Street 1:11646 INDUSTRIPLEX BLVD
Practice Address - Street 2:SUITE A 3
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-5192
Practice Address - Country:US
Practice Address - Phone:225-687-7195
Practice Address - Fax:225-752-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1177946Medicaid
LA1177946Medicaid