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General NPI Number Information
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NPI Number | 1316982499
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Entity Type | Organization
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Legal Business Name | SHREVEPORT OXYGEN & RENTAL, LLC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 5150 INTERSTATE DR., STE. 216
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City | SHREVEPORT
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State | LA
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Zip | 71109
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Country | US
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Telephone | 318-631-4755
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Fax | 318-631-4211
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Provider Business Mailing Address
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Address Line | 5150 INTERSTATE DR., STE. 216
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City | SHREVEPORT
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State | LA
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Zip | 71109
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Country | US
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Telephone | 318-631-4755
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Fax | 318-631-4211
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Authorized Official
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Title or Position | OWNER
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Name | SUSAN T. MCFARLAIN
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Credential |
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Telephone | 318-631-4755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 09-0011094
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License Number State | LA
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