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Organization
BEAUREGARD MEDICAL SUPPLY LLC
Active
Organization
BEAUREGARD MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LOFTIN (PRESIDENT)
(337) 842-6142
Entity
Organization
Contact information
Practice address
1004 N PINE ST, B, DERIDDER, LA 70634-2818
(337) 842-6142
Mailing address
1004 N PINE ST, B, DERIDDER, LA 70634-2818
(337) 842-6142
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
40679808K
LA
Other
Enumeration date
01/02/2012
Last updated
01/02/2012
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