EBENEZER SUPPLIES INC (NPI# 1407019227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407019227 |
| Entity Type | Organization |
| Organization Name | EBENEZER SUPPLIES INC |
| Practice Address |
2924 Knight St Ste 412 Shreveport LA 71105-2413 |
| Mailing Address |
2924 Knight St Shreveport LA 71105-2413 |
| Practice Telephone | 3188681349 |
| Practice Fax Number | 3188681350 |
| Mailing Telephone | 3188681349 |
| Mailing Fax Number | 3188681350 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |
| Authorized Official Name | MR. GODWIN O ENYONG JR. (PRESIDENT) |
| Authorized Official Telephone | 3188681349 |
| Authorized Official Credential | INC. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
2924 KNIGHT ST STE 412 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-2413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325854 | Morning Star Medical | Durable Medical Equipment & Medical Supplies | 456 W 61st St, Shreveport, LA 71106-2511 | 2020-08-06 |
| 1982253340 | Total Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 333 Texas St Ste 1111, Shreveport, LA 71101-5303 | 2019-09-09 |
| 1548611288 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 9484 Ellerbe Rd Ste 100, Shreveport, LA 71106 | 2016-06-23 |
| 1750730057 | Louisiana Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 10460 Norris Ferry Rd, Shreveport, LA 71106 | 2016-06-07 |
| 1396117735 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4701 Northport Blvd, Shreveport, LA 71107 | 2015-10-26 |
| 1437521879 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 412 Bert Kouns Industrial Loop, Shreveport, LA 71106-8127 | 2015-10-26 |
| 1871905992 | Tap-alert | Durable Medical Equipment & Medical Supplies | 3305 W 70th St Unit D, Shreveport, LA 71108-4609 | 2014-05-23 |
| 1558709279 | Nla Medical LLC | Durable Medical Equipment & Medical Supplies | 8125 Captain Mary Miller Dr, Shreveport, LA 71115-2982 | 2013-06-05 |
| 1225381981 | Med Health Depot, LLC | Durable Medical Equipment & Medical Supplies | 6658 Youree Dr, Suite 180 #298, Shreveport, LA 71105-4648 | 2012-10-18 |
| 1902176142 | Louisiana Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 9510 Ellerbe Rd, Shreveport, LA 71106-7406 | 2012-01-05 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on EBENEZER SUPPLIES INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.