Organization
ASSOCIATED MEDICAL & OXYGEN SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DARREL COATES (PRESIDENT)
(318) 798-6004
Entity
Organization
Contact information
Practice address
8870 YOUREE DR STE 107, SHREVEPORT, LA 71115-2512
(318) 798-6004
(318) 798-9570
Mailing address
8870 YOUREE DR STE 107, SHREVEPORT, LA 71115-2512
(318) 798-6004
(318) 798-9570
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
090009644
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1656381
—
LA
01
—
B7498
BCBS DME PROVIDER NUMBER
LA
Enumeration date
01/18/2007
Last updated
08/18/2009
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