Organization
LOUISIANA HOME MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS FULTON DEVALL (OWNER)
(225) 683-4878
Entity
Organization
Contact information
Practice address
17943 HIGHWAY 432, CLINTON, LA 70722-4027
(225) 683-4878
(225) 683-4869
Mailing address
POST OFFICE BOX 8189, CLINTON, IA 70722-1189
(225) 683-4878
(225) 683-4869
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1160636
—
LA
Enumeration date
02/20/2007
Last updated
02/26/2008
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