Provider Demographics
NPI:1366881153
Name:MELANCON MEDICAL EQUIPMENT AND SUPPLIES
Entity type:Organization
Organization Name:MELANCON MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:JUDE
Authorized Official - Last Name:MELANCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-376-6383
Mailing Address - Street 1:709 S LEWIS ST STE E
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4858
Mailing Address - Country:US
Mailing Address - Phone:337-376-6383
Mailing Address - Fax:337-376-6385
Practice Address - Street 1:709 S LEWIS ST STE E
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4858
Practice Address - Country:US
Practice Address - Phone:337-376-6383
Practice Address - Fax:337-376-6385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-14
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies