Organization
IBERVILLE MEDICAL SUPPLIES STORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEE ANN HAGGENS (OWNER)
(225) 385-3155
Entity
Organization
Contact information
Practice address
58610 BELLEVIEW DR, PLAQUEMINE, LA 70764-3900
(225) 385-3155
(225) 687-6311
Mailing address
58610 BELLEVIEW DR, PLAQUEMINE, LA 70764-3900
(225) 385-3155
(225) 687-6311
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
LA
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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