Provider Demographics
NPI:1174745533
Name:ONE STOP SCOOTER SHOP & MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:ONE STOP SCOOTER SHOP & MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANIKA
Authorized Official - Middle Name:DESHAN
Authorized Official - Last Name:PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-949-2989
Mailing Address - Street 1:80 DEREK LANE
Mailing Address - Street 2:
Mailing Address - City:LAPLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-8400
Mailing Address - Country:US
Mailing Address - Phone:800-949-2989
Mailing Address - Fax:504-864-8027
Practice Address - Street 1:8124 OAK ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-2040
Practice Address - Country:US
Practice Address - Phone:800-949-2989
Practice Address - Fax:504-864-8027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1178250Medicaid
LA1178250Medicaid