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Organization

BEAUREGARD MEDICAL SUPPLY

Active
Other names
Beauregard Medical Supply
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY GONZALEZ COMPLIANCE OFFICER (COMPLIANCE OFFICE/MGR)
(337) 463-8850
Entity
Organization

Contact information

Practice address
1512 N. PINE STREET, STE B, DERIDDER, LA 70634-2418
(337) 463-8850
(337) 463-8850
Mailing address
1512 N. PINE STREET, STE B, DERIDDER, LA 70634-2418
(337) 463-8850
(337) 463-8850

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2189867
LA
Enumeration date
01/17/2019
Last updated
02/11/2025
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