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General NPI Number Information
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NPI Number | 1306969845
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Entity Type | Organization
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Legal Business Name | SOUTHERN DME CO, LLC
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8140 TRANQUILITY CIR
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City | DENHAM SPRINGS
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State | LA
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Zip | 70706-2038
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Country | US
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Telephone | 225-667-3685
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 TRANQUILITY CIR
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City | DENHAM SPRINGS
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State | LA
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Zip | 70706-2038
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CINDY SAVARESE
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Credential |
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Telephone | 225-667-3685
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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 | 21649
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License Number State | LA
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