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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANN M WARD (OWNER)
(318) 396-6789
Entity
Organization

Contact information

Practice address
2002 E KENTUCKY AVE, RUSTON, LA 71270-6623
(318) 255-5131
(318) 255-5769
Mailing address
2002 E KENTUCKY AVE, RUSTON, LA 71270-6623
(318) 255-5131
(318) 255-5769

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1533734
LA
01
C6819
BLUE CROSS PROV. NUMBER
LA
Enumeration date
06/02/2005
Last updated
08/22/2020
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