Organization
FRESH AIR MEDICAL EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE CLARK (MANAGER)
(318) 628-4447
Entity
Organization
Contact information
Practice address
103 W BOUNDARY AVE, SUITE 116, WINNFIELD, LA 71483-2757
(318) 628-4447
(318) 628-4430
Mailing address
103 W BOUNDARY AVE, SUITE 116, WINNFIELD, LA 71483-2757
(318) 628-4447
(318) 628-4430
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00065220
STATE GROUP PAYEE NUMB
LA
01
—
C0218
BCBS PROVIDER NUMB
LA
Enumeration date
02/08/2007
Last updated
09/11/2025
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