Provider Demographics
NPI:1689434060
Name:LA DME MEDICAL
Entity type:Organization
Organization Name:LA DME MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-495-5546
Mailing Address - Street 1:4654 E AVENUE S # 173
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-4454
Mailing Address - Country:US
Mailing Address - Phone:661-825-7473
Mailing Address - Fax:
Practice Address - Street 1:38733 9TH ST E STE Q
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2910
Practice Address - Country:US
Practice Address - Phone:661-495-5546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies