Provider Demographics
NPI:1447218680
Name:GOLDEN MEDICAL EQUIPMENT&SUPPLY, INC.
Entity type:Organization
Organization Name:GOLDEN MEDICAL EQUIPMENT&SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IMEH
Authorized Official - Middle Name:A
Authorized Official - Last Name:EBERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-925-2733
Mailing Address - Street 1:2708 WOODDALE BLVD
Mailing Address - Street 2:SUITEA, ROOM1
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70805-7541
Mailing Address - Country:US
Mailing Address - Phone:225-925-2733
Mailing Address - Fax:225-925-2734
Practice Address - Street 1:2708 WOODDALE BLVD
Practice Address - Street 2:SUITEA, ROOM1
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70805-7541
Practice Address - Country:US
Practice Address - Phone:225-925-2733
Practice Address - Fax:225-925-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1156523Medicaid
LA4688830001Medicare ID - Type UnspecifiedPROVIDER NUMBER