Organization
ANGEL MEDICAL SUPPLY CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A MAYEUX (PRES CEO)
(225) 930-9944
Entity
Organization
Contact information
Practice address
1723 DALLAS DR, STE C, BATON ROUGE, LA 70806-1453
(225) 930-9944
(225) 921-0212
Mailing address
1723 DALLAS DR, STE C, BATON ROUGE, LA 70806-1453
(225) 930-9944
(225) 921-0212
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1105112
—
LA
Enumeration date
08/30/2005
Last updated
08/22/2020
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