Healthcare Provider Details

I. General information

NPI: 1497785299
Provider Name (Legal Business Name): LOUISIANA MOBILITY OF CENTRAL LA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 10/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5508 MONROE HWY
BALL LA
71405
US

IV. Provider business mailing address

5508 MONROE HWY
BALL LA
71405
US

V. Phone/Fax

Practice location:
  • Phone: 318-640-0988
  • Fax: 318-640-0927
Mailing address:
  • Phone: 318-640-0988
  • Fax: 318-640-0927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0198150-001
License Number StateLA

VIII. Authorized Official

Name: MR. FRANCES HARRISON
Title or Position: CEO/OWNER
Credential:
Phone: 601-914-1004