Organization
HAVEN MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER A DONALIES (BUSINESS OFFICE/ AR)
(318) 649-9809
Entity
Organization
Contact information
Practice address
7726 US HWY 165, COLUMBIA, LA 71418-7726
(318) 649-9809
(318) 649-9825
Mailing address
7726 US HWY 165, COLUMBIA, LA 71418-7726
(318) 649-9809
(318) 649-9825
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
010703002000
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1382655
—
LA
Enumeration date
12/19/2005
Last updated
08/22/2020
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