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General NPI Number Information
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NPI Number | 1225142870
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Entity Type | Organization
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Legal Business Name | MOBILITY PLUS MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 1013 E MCNEESE ST STE B
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City | LAKE CHARLES
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State | LA
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Zip | 70607-5837
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Country | US
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Telephone | 337-474-1874
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Fax | 337-474-1873
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Provider Business Mailing Address
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Address Line | PO BOX 16672
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City | LAKE CHARLES
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State | LA
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Zip | 70616-6672
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Country | US
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Telephone | 337-474-1874
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Fax | 337-474-1873
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | MRS. JOYCE M COWARD
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Credential | DME
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Telephone | 337-474-1874
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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 | 1862689001
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License Number State | LA
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