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General NPI Number Information
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NPI Number | 1447395256
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Entity Type | Organization
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Legal Business Name | LOUISIANA HOME MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 17943 HIGHWAY 432
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City | CLINTON
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State | LA
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Zip | 70722-4027
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Country | US
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Telephone | 225-683-4878
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Fax | 225-683-4869
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Provider Business Mailing Address
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Address Line | POST OFFICE BOX 8189
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City | CLINTON
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State | IA
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Zip | 70722-1189
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Country | US
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Telephone | 225-683-4878
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Fax | 225-683-4869
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Authorized Official
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Title or Position | OWNER
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Name | MR. DENNIS FULTON DEVALL
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Credential |
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Telephone | 225-683-4878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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