Organization
THE MOBILITY DEPOT OF MONROE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH MENVILLE (OWNER)
(225) 215-2222
Entity
Organization
Contact information
Practice address
1300 CYPRESS ST, WEST MONROE, LA 71291-2710
(318) 322-2474
(318) 322-2479
Mailing address
7931 ONE CALAIS AVE, BATON ROUGE, LA 70809-3403
(225) 215-2222
(225) 215-2221
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0600002125
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1131105
—
LA
Enumeration date
02/12/2007
Last updated
08/22/2020
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