Organization
CRESCENT CITY FACEDOWN RECOVERY SYSTEMS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HENRY NUSS (OWNER)
(504) 442-9050
Entity
Organization
Contact information
Practice address
1530 LAPALCO BLVD, SUITE 21, HARVEY, LA 70058-5739
(504) 442-9050
Mailing address
123 AVALON PL, HAHNVILLE, LA 70057-2015
(504) 444-3389
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
DME.000824
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DME.000824
LOUISIANA BOARD OF PHARMACY DME LICENSE PROVIDER
LA
Enumeration date
04/24/2017
Last updated
04/24/2017
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