Organization
AXIS MEDICAL & FITNESS EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS E CUPPLES II (OWNER)
(318) 427-9030
Entity
Organization
Contact information
Practice address
1616 EVARIST ST, ALEXANDRIA, LA 71301-3414
(318) 427-9030
(318) 427-1818
Mailing address
1616 EVARIST ST, ALEXANDRIA, LA 71301-3414
(318) 427-9030
(318) 427-1818
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00107187
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1459615
—
LA
Enumeration date
12/18/2006
Last updated
12/04/2007
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