Organization
FAVORED MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIEL WILLIAMS (MARKETING EXECUTIVE)
(337) 438-1645
Entity
Organization
Contact information
Practice address
1609 ORCHID ST, LAKE CHARLES, LA 70601-7779
(337) 438-1645
Mailing address
1609 ORCHID ST, LAKE CHARLES, LA 70601-7779
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00038203
LA
Other
Enumeration date
08/03/2009
Last updated
08/03/2009
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