Active Life Medical

LBN: Active Life Medical Management
Active Life Medical is an health care organization with primary practice located at 4501 Jackson St Ste. C-322, Alexandria LA 71303-2555. The organization recently has 5 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Customized Equipment, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Oxygen Equipment & Supplies. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty. Active Life Medical Management can be contacted via phone (318) 442-2200, or through Souza, Jeffrey via phone (318) 442-2200.

Contact Information

Primary practice address
4501 Jackson St Ste. C-322 Alexandria LA 71303-2555
Phone: (318) 442-2200
Fax: (318) 442-2208
Website:
Map and Directions
Authorized official contact:
Name: Souza, Jeffrey
Phone: (318) 442-2200

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Customized Equipment 332BC3200X DME000481 Louisiana
Suppliers / Nursing Facility Supplies 332BN1400X DME000481 Louisiana
Suppliers / Parenteral & Enteral Nutrition 332BP3500X DME000481 Louisiana
Suppliers / Oxygen Equipment & Supplies 332BX2000X DME000481 Louisiana

Profile Details

NPI number 1134507908
LBN Legal business name Active Life Medical Management
DBA Doing business as Active Life Medical
Authorized official Souza, Jeffrey
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2015
Last updated May 13th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134507908 NPPES
Louisiana Other DME000481 LA PHARMACY LICENSE

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