Organization
MIDSOUTH MEDICAL INC
Active
Other names
Delta Drug Co, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA JONES (OWNER)
(318) 855-0411
Entity
Organization
Contact information
Practice address
3209 BREARD ST, MONROE, LA 71201-3911
(318) 855-0411
(855) 420-5858
Mailing address
PO BOX 4927, MONROE, LA 71211-4927
(318) 855-0411
(855) 420-5858
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
35109770D
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1468452
—
LA
01
—
G2094
BCBS OF LA
LA
Enumeration date
03/31/2006
Last updated
07/08/2022
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