Provider Demographics
NPI:1881910941
Name:FIRST CENTURY MEDICAL SUPPLY,INC
Entity type:Organization
Organization Name:FIRST CENTURY MEDICAL SUPPLY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUZIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-575-0211
Mailing Address - Street 1:637 S PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6805
Mailing Address - Country:US
Mailing Address - Phone:504-575-0211
Mailing Address - Fax:504-304-6691
Practice Address - Street 1:637 S PIERCE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6805
Practice Address - Country:US
Practice Address - Phone:504-575-0211
Practice Address - Fax:504-304-6691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA23160332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment