Organization
REGGIE GREEN
Active
Other names
AYS MEDICAL SUPPLY COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGGIE DEMONE GREEN (OWNER)
(225) 644-6514
Entity
Organization
Contact information
Practice address
105 W CORNERVIEW ST, SUITE B, GONZALES, LA 70737-2839
(225) 644-6514
(225) 644-6514
Mailing address
105 WEST CORNERVIEW, BLDG B, GONZALES, LA 70737-8509
(225) 803-3122
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
02879
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527297
—
LA
Enumeration date
10/11/2006
Last updated
04/29/2008
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