Organization
SOUTH SHREVE MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES D MACEY CPA (CONTROLLER)
(318) 798-2648
Entity
Organization
Contact information
Practice address
8520 BUSINESS PARK DR, SHREVEPORT, LA 71105-5654
(318) 798-2648
(318) 798-3451
Mailing address
PO BOX 52389, SHREVEPORT, LA 71135-2389
(318) 798-2648
(318) 798-3451
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
Other
Enumeration date
01/15/2007
Last updated
08/22/2020
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