Healthcare Provider Details

I. General information

NPI: 1922931823
Provider Name (Legal Business Name): AMZ SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 VIRGINIA ST APT 7
MONROE LA
71203-3975
US

IV. Provider business mailing address

111 VIRGINIA ST APT 7
MONROE LA
71203-3975
US

V. Phone/Fax

Practice location:
  • Phone: 226-538-0461
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: WILSON ROSHAE
Title or Position: CE0
Credential:
Phone: 226-538-0614