Organization
PREMIER MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROD MILLIMAN (MEMBER/MANAGER)
(318) 387-2488
Entity
Organization
Contact information
Practice address
1821 ROYAL AVE, SUITE 5, MONROE, LA 71201-5721
(318) 387-2488
(318) 387-2420
Mailing address
1821 ROYAL AVE, SUITE 5, MONROE, LA 71201-5721
(318) 387-2488
(318) 387-2420
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2134396
—
LA
Enumeration date
08/06/2010
Last updated
05/11/2011
Update your record
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