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FUNCTIONAL DME NPI 1407347586


NPI Information

NPI: 1407347586
Provider Name: FUNCTIONAL DME
Classification: Prosthetic/Orthotic Supplier - 335E00000X
Entity Type: Organization
Address:
930B PRAYER HOUSE RD
WASHINGTON, LA
ZIP 70589
Phone: (225) 412-9955
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FUNCTIONAL DME is a prosthetic orthotic supplier in Washington, LA. The provider is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. FUNCTIONAL DME NPI is 1407347586. The provider is registered as an organization entity type.

The provider's business location address is:

930B PRAYER HOUSE RD
WASHINGTON, LA
ZIP 70589-113
Phone: (225) 412-9955
Fax: (225) 412-9957

The provider's authorized official is Colleen Ryan .
The authorized official title is Owner and has the following contact phone number (225) 412-9955.

The enumeration date for this NPI number is 5/23/2018 and was last updated on 2/3/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2335E00000XProsthetic/Orthotic SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12494589MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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