MEDICARE: RX MEDICAL PRODUCTS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1194925180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RX MEDICAL PRODUCTS LLC

Provider Business Mailing Address
First Line	:	3825 GILBERT DR
Second Line	:	SUITE 201
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-5000
Country	:	US
Telephone Number	:	318-564-7826
Fax Number	:	318-861-5921

Provider Business Practice Location Address
First Line	:	3825 GILBERT DR
Second Line	:	SUITE 201
City	:	SHREVEPORT
State	:	LA
Zip	:	71104-5000
Country	:	US
Telephone Number	:	318-564-7826
Fax Number	:	318-861-5921

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. IRA VERNON HASTINGS III
Credential	:
Telephone Number	:	318-564-7826

Provider Enumeration Date	:	07/19/2007
Last Update Date	:	07/19/2007

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Directions to “RX MEDICAL PRODUCTS LLC ” Practice Location

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