Healthcare Provider Details

I. General information

NPI: 1639339526
Provider Name (Legal Business Name): HERMANN MEDICAL SUPPLIES III, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1018 N MARTIN LUTHER KING HWY
LAKE CHARLES LA
70601-2046
US

IV. Provider business mailing address

1018 N MARTIN LUTHER KING HWY
LAKE CHARLES LA
70601-2046
US

V. Phone/Fax

Practice location:
  • Phone: 337-433-6842
  • Fax: 337-494-7059
Mailing address:
  • Phone: 337-433-6842
  • Fax: 337-494-7059

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: ABIGAIL GREENE
Title or Position: PRESIDENT
Credential:
Phone: 281-392-1114