Organization
DELTA RURAL MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GREESON (MANAGER)
(318) 728-7177
Entity
Organization
Contact information
Practice address
1028 HARRISON STREET, 1028 HARRISON STREET, RAYVILLE, LA 71269
(318) 728-7177
(318) 728-7186
Mailing address
1028 HARRISON STREET, 1028 HARRISON STREET, RAYVILLE, LA 71269
(318) 728-7177
(318) 728-7186
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07531271
—
MS
05
—
1994669
—
LA
Enumeration date
10/20/2006
Last updated
07/23/2008
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