Organization
PROVISION MEDICAL SUPPY LLC
Active
Other names
Provision Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS L GIVS (OWNER)
(337) 504-5455
Entity
Organization
Contact information
Practice address
1001 W PINHOOK RD, SUITE 223A, LAFAYETTE, LA 70503-2448
(337) 504-5455
(337) 504-5456
Mailing address
1001 W PINHOOK RD, SUITE 223A, LAFAYETTE, LA 70503-2448
(337) 504-5455
(337) 504-5456
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
3219516-001
LA
Other
Enumeration date
11/06/2006
Last updated
03/10/2008
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