Organization
FERGUSONS LA TIENDA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA C FERGUSON CMF (OWNER, MANAGER & FITTER)
(318) 675-0180
Entity
Organization
Contact information
Practice address
2601 LINE AVE, SUITE C, SHREVEPORT, LA 71104-3023
(318) 675-0180
(318) 675-0190
Mailing address
PO BOX 6689, SHREVEPORT, LA 71136-6689
(318) 675-0180
(318) 675-0190
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1322059
—
LA
Enumeration date
02/13/2007
Last updated
09/22/2008
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