Organization
RIVERSIDE MEDICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE SUE FREEMAN (PRESIDENT)
(318) 757-6292
Entity
Organization
Contact information
Practice address
208 MICKEY GILLEY AVE, FERRIDAY, LA 71334-2834
(318) 757-2530
(318) 757-2540
Mailing address
PO BOX 326, 208 MICKEY GILLEY AVENUE, FERRIDAY, LA 71334-0326
(318) 757-2530
(318) 757-2540
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/20/2009
Last updated
05/10/2010
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