Healthcare Provider Details
I. General information
NPI: 1255382123
Provider Name (Legal Business Name): PHYSICIAN'S CHOICE HOME MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2006
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1509 DOCTORS DR
BOSSIER CITY LA
71111-3321
US
IV. Provider business mailing address
1330 SHREVEPORT BARKSDALE HWY
SHREVEPORT LA
71105-2408
US
V. Phone/Fax
- Phone: 318-746-6288
- Fax: 318-746-7911
- Phone: 318-746-6288
- Fax: 318-746-7911
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 080011399 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CLAUDE
N
FRIESLAND
JR.
Title or Position: PRESIDENT/CEO
Credential:
Phone: 318-746-6288