Organization
EBENEZER SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GODWIN O ENYONG JR. INC. (PRESIDENT)
(318) 868-1349
Entity
Organization
Contact information
Practice address
2924 KNIGHT ST STE 412, SHREVEPORT, LA 71105-2413
(318) 868-1349
(318) 868-1350
Mailing address
2924 KNIGHT ST, SHREVEPORT, LA 71105-2413
(318) 868-1349
(318) 868-1350
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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