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Organization

GULF STATES MEDICAL SUPPLY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BLAKE NICHOLSON (MANAGING PARTNER)
(337) 364-8881
Entity
Organization

Contact information

Practice address
4801 ERASTE HEBERT RD, NEW IBERIA, LA 70560-0839
(337) 364-8881
(337) 364-8862
Mailing address
4801 ERASTE HEBERT RD, NEW IBERIA, LA 70560-0839
(337) 364-8881
(337) 364-8862

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
12/20/2010
Last updated
07/29/2014
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