SOUTH SHREVE MEDICAL SUPPLIES, INC. (NPI# 1619028917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619028917 |
| Entity Type | Organization |
| Organization Name | SOUTH SHREVE MEDICAL SUPPLIES, INC. |
| Practice Address |
8520 Business Park Dr Shreveport LA 71105-5654 |
| Mailing Address |
Po Box 52389 Shreveport LA 71135-2389 |
| Practice Telephone | 3187982648 |
| Practice Fax Number | 3187983451 |
| Mailing Telephone | 3187982648 |
| Mailing Fax Number | 3187983451 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHARLES D MACEY (CONTROLLER) |
| Authorized Official Telephone | 3187982648 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers |
| Street Address |
8520 BUSINESS PARK DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5654 |
| 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 | 332BN1400X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Nursing Facility Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730124488 | Virginia Hall Nursing Home | Durable Medical Equipment & Medical Supplies | 2715 Albert L Bicknell Dr, Shreveport, LA 71103-3925 | 2006-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164577276 | Emerald Medical Supply | Durable Medical Equipment & Medical Supplies | 39362 Meadowbrook Ave, Prairieville, LA 70769-4836 | 2007-01-25 |
| 1659380004 | Southern Acres Care Center, Lp | Durable Medical Equipment & Medical Supplies | 4600 Reddix Ln, Monroe, LA 71202-5949 | 2006-08-05 |
| 1518911205 | Regional Health Services LLC | Durable Medical Equipment & Medical Supplies | 203 Four Park Rd, Lafayette, LA 70507-2481 | 2006-05-19 |
| 1609865096 | Acadian Oaks Nursing Home LLC | Durable Medical Equipment & Medical Supplies | 2707 Kaliste Saloom Rd, Lafayette, LA 70508-7139 | 2005-10-18 |
| 1194710590 | Brown Development, LLC | Durable Medical Equipment & Medical Supplies | 32 Crothers Dr, Tallulah, LA 71282-5510 | 2005-09-13 |
| 1245231992 | Notre Dame Health System | Durable Medical Equipment & Medical Supplies | 1050 Medical Center Blvd, Marrero, LA 70072-3144 | 2005-08-03 |
| 1609876267 | Express Medical Products, Inc. | Durable Medical Equipment & Medical Supplies | 301 Veterans Blvd, Denham Springs, LA 70726-4722 | 2005-07-26 |
| 1972502185 | Ollie Steele Burden Manor, Inc | Durable Medical Equipment & Medical Supplies | 7435 Bishop Ott Drive, Baton Rouge, LA 70806-8930 | 2005-07-19 |
| 1386031235 | Carmichael's Cashway Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 4809 Ambassador Caffery Pkwy, Suite 220, Lafayette, LA 70508-8800 | 2015-04-17 |
| 1396171690 | A&b Medical Supply | Durable Medical Equipment & Medical Supplies | 711 E Laurel Ave, Suite G, Eunice, LA 70535-3515 | 2013-09-18 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on SOUTH SHREVE MEDICAL 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.