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Organization
RED BALL MEDICAL SUPPLY, INC
Active
Organization
RED BALL MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH K STORER (PRESIDENT / OWNER)
(318) 424-8393
Entity
Organization
Contact information
Practice address
1020 N MARKET ST, SHREVEPORT, LA 71107-6747
(318) 424-8393
(318) 222-6104
Mailing address
PO BOX 7623, SHREVEPORT, LA 71137-7623
(318) 424-8393
(318) 222-6104
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
09-0007047
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
4028
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316792
—
LA
01
—
27623
BLUE CROSS
LA
01
—
56735
NORTHWOOD
LA
Enumeration date
12/19/2005
Last updated
03/16/2011
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