Healthcare Provider Details
I. General information
NPI: 1982914982
Provider Name (Legal Business Name): JOY MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/09/2010
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
306 N BURNSIDE AVE
GONZALES LA
70737
US
IV. Provider business mailing address
306 N BURNSIDE AVE
GONZALES LA
70737
US
V. Phone/Fax
- Phone: 225-644-2910
- Fax: 225-644-0247
- Phone: 225-644-2910
- Fax: 225-644-0247
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 04225 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
THUAN
TOMMY
NGUYEN
Title or Position: CEO CHEIF EXECUTIVE OFFICER
Credential:
Phone: 225-644-2910