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General NPI Number Information
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NPI Number | 1609526383
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Entity Type | Organization
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Legal Business Name | STANDARD MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 03/25/2022
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Provider Practice Location Address
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Address Line | 804 COLONY PL
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City | METAIRIE
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State | LA
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Zip | 70003-2414
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Country | US
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Telephone | 504-442-5245
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Fax |
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Provider Business Mailing Address
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Address Line | 804 COLONY PL
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City | METAIRIE
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State | LA
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Zip | 70003-2414
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Country | US
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Telephone | 504-442-5245
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. CRAIG MICHAEL HEFLER JR.
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Credential |
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Telephone | 504-442-5245
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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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