Healthcare Provider Details

I. General information

NPI: 1780767715
Provider Name (Legal Business Name): LOUISIANA NURSING SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 INDEPENDENCE DR
ALEXANDRIA LA
71303-3533
US

IV. Provider business mailing address

PO BOX 12957
ALEXANDRIA LA
71315-2957
US

V. Phone/Fax

Practice location:
  • Phone: 318-487-8891
  • Fax: 318-484-9806
Mailing address:
  • Phone: 318-487-8891
  • Fax: 318-484-9806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. JUNE PEACH
Title or Position: OWNER
Credential:
Phone: 318-487-8891