Organization
ACTIVE LIFE AND HEALTH INC
Active
Other names
Active Life Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY A SOUZA (PRESIDENT)
(888) 525-0255
Entity
Organization
Contact information
Practice address
3600 JACKSON STREET EXT, ALEXANDRIA, LA 71303-3040
(888) 525-0255
(888) 525-0255
Mailing address
PO BOX 586, YUBA CITY, CA 95992-0586
(888) 525-0255
(888) 525-0255
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
03/25/2011
Last updated
07/21/2013
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