Provider Demographics
NPI:1619016565
Name:M & D ENTERPRISES, LLC
Entity type:Organization
Organization Name:M & D ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MIKEL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:318-286-4810
Mailing Address - Street 1:3825 GILBERT DR
Mailing Address - Street 2:SUITE 118
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-5000
Mailing Address - Country:US
Mailing Address - Phone:318-286-4810
Mailing Address - Fax:318-861-5998
Practice Address - Street 1:3825 GILBERT DR
Practice Address - Street 2:SUITE 118
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71104-5000
Practice Address - Country:US
Practice Address - Phone:318-286-4810
Practice Address - Fax:318-861-5998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies