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General NPI Number Information
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NPI Number | 1114208329
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Entity Type | Organization
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Legal Business Name | SHARICK MEDICAL SUPPLY, EQUIPMENT AND HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 419 COLUMBIA ST STE G
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City | BOGALUSA
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State | LA
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Zip | 70427-4500
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Country | US
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Telephone | 985-732-1827
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 S ROYAL ST
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City | BOGALUSA
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State | LA
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Zip | 70427-5458
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Country | US
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Telephone | 985-732-1827
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. SHAWN CHATMON RATLIFF
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Credential |
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Telephone | 985-732-1827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 40591732D
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License Number State | LA
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