MEDICARE: REHOBOTH EQUIPMENT, INC.

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	:	1255537494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHOBOTH EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	2438 E TEXAS ST
Second Line	:	7
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-3737
Country	:	US
Telephone Number	:	318-549-0120
Fax Number	:	318-549-0121

Provider Business Practice Location Address
First Line	:	2438 E TEXAS ST
Second Line	:	7
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-3737
Country	:	US
Telephone Number	:	318-549-0120
Fax Number	:	318-549-0121

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GODSPOWER J ESSANG
Credential	:
Telephone Number	:	318-549-0120

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	08/22/2020

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