Organization
DURAMED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICKY WALTER DECASTRO SR. (PRESIDENT/OWNER)
(504) 467-4057
Entity
Organization
Contact information
Practice address
1015 24TH ST, KENNER, LA 70062-5268
(504) 467-4057
(504) 467-4053
Mailing address
1015 24TH ST, KENNER, LA 70062-5268
(504) 467-4057
(504) 467-4053
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669814
—
LA
01
—
B6939
BCBS PROVIDER #
LA
Enumeration date
06/22/2006
Last updated
01/13/2011
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