Organization
MR. WHEELCHAIR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN BRAUER (MANAGER)
(504) 834-2810
Entity
Organization
Contact information
Practice address
1201 JEFFERSON HWY, SUITE A, JEFFERSON, LA 70121-2439
(504) 834-2810
(504) 828-6457
Mailing address
1201 JEFFERSON HWY, SUITE A, JEFFERSON, LA 70121-2439
(504) 834-2810
(504) 828-6457
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1661287
—
LA
01
—
C6490
BCBS OF LA PROVIDER #
LA
Enumeration date
12/30/2005
Last updated
07/01/2011
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