Organization
ADVANCED LASER EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AARON BODIN (OWNER)
(985) 384-0802
Entity
Organization
Contact information
Practice address
1201 BRASHEAR AVE, 430, MORGAN CITY, LA 70380-1361
(985) 384-0802
(985) 384-1585
Mailing address
1201 BRASHEAR AVE, 430, MORGAN CITY, LA 70380-1361
(985) 384-0802
(985) 384-1585
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1072877
—
LA
01
—
2742187-002
STATE TAX ID NUMBER
LA
01
—
H2253
BLUECROSS/BLUESHIELD
LA
Enumeration date
09/06/2007
Last updated
06/21/2018
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