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General NPI Number Information
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NPI Number | 1689619520
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Entity Type | Organization
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Legal Business Name | TALBERT'S MEDICAL LLC
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 1011 LAKE SHORE DR SUITE 521
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City | LAKE CHARLES
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State | LA
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Zip | 70601-9412
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Country | US
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Telephone | 337-439-2119
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Fax | 337-439-2120
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Provider Business Mailing Address
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Address Line | PO BOX 580
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City | LAKE CHARLES
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State | LA
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Zip | 70602-0580
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Country | US
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Telephone | 337-439-2119
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Fax | 337-439-2120
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY LOUISE TALBERT
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Credential |
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Telephone | 337-439-2119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition 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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | LA
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Taxonomy #3
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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 #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | LA
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