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General NPI Number Information
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NPI Number | 1578644084
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Entity Type | Organization
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Legal Business Name | LEWIS MEDICAL SUPPLY
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15254 LEWIS ROAD
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City | ROSELAND
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State | LA
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Zip | 70456
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Country | US
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Telephone | 985-969-6755
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Fax | 225-612-5937
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Provider Business Mailing Address
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Address Line | P O BOX 1207
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City | ROSELAND
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State | LA
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Zip | 70456
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Country | US
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Telephone | 985-969-6755
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Fax | 225-612-5937
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. ROBERT LEE LEWIS JR.
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Credential |
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Telephone | 985-969-6755
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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 | 35800420K
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License Number State | LA
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