Organization
MOBILITY PRODUCTS DEPOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W. LANDRY (OWNER)
(337) 504-2743
Entity
Organization
Contact information
Practice address
510 LAFAYETTE STREET, YOUNGSVILLE, LA 70592
(337) 504-2743
(337) 504-3014
Mailing address
PO BOX 840, YOUNGSVILLE, LA 70592-0840
(337) 504-2743
(337) 504-3014
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1142808
—
LA
01
—
G5891
BLUE CROSS BLUE SHIELD
LA
Enumeration date
07/01/2005
Last updated
07/28/2008
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