Organization
SCOOTER STORE - SHREVEPORT LLC
Active
Parent organization
THE SCOOTER STORE - USA, INC.
Other names
The SCOOTER Store/Alliance Seating and Mobility
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE SCOOTER STORE - USA, INC.
Authorized official
JASON CONE (GENERAL COUNSEL & SECRETARY)
(830) 627-4433
Entity
Organization
Contact information
Practice address
9644 SAINT VINCENT AVE, SHREVEPORT, LA 71106-7127
(318) 865-1564
Mailing address
PO BOX 310709, NEW BRAUNFELS, TX 78131-0709
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1120006
—
LA
05
—
149016716
—
AR
05
—
157486501
—
TX
05
—
157486502
—
TX
05
—
157486503
—
TX
05
—
157486504
—
TX
Enumeration date
07/25/2006
Last updated
08/09/2013
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