Healthcare Provider Details

I. General information

NPI: 1043212723
Provider Name (Legal Business Name): ANN WARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 CYPRESS ST SUITE 5
WEST MONROE LA
71291-7670
US

IV. Provider business mailing address

PO BOX 698
RUSTON LA
71273-0698
US

V. Phone/Fax

Practice location:
  • Phone: 318-396-6789
  • Fax: 318-396-0321
Mailing address:
  • Phone: 318-255-5131
  • Fax: 318-396-0321

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: ANN M WARD
Title or Position: OWNER
Credential:
Phone: 318-255-5131