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General NPI Number Information
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NPI Number | 1245388610
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Entity Type | Organization
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Legal Business Name | EVANGELINE MEDICAL & NURSING SUPPLY, INC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 107 HOSPITAL DR
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City | OAKDALE
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State | LA
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Zip | 71463-3034
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Country | US
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Telephone | 318-335-0520
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Fax | 318-335-0508
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Provider Business Mailing Address
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Address Line | 107 HOSPITAL DR
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City | OAKDALE
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State | LA
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Zip | 71463-3034
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Country | US
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Telephone | 318-335-0520
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Fax | 318-335-0508
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Authorized Official
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Title or Position | CO OWNER
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Name | MR. BRETT DAVID MCELWEE
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Credential | RN CO OWNER
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Telephone | 337-363-3638
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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 | 2700326001
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License Number State | LA
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