Basic Information
| Provider Information | |||||||||
| NPI: | 1407082662 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MEDICAL EQUIPMENT SOLUTIONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3510 LINWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711034512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186364194 | ||||||||
| FaxNumber: | 3186364196 | ||||||||
| Practice Location | |||||||||
| Address1: | 5150 INTERSTATE DR | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711096515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3185724400 | ||||||||
| FaxNumber: | 3186364194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2009 | ||||||||
| LastUpdateDate: | 06/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | THROWER | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | CO-MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 3186364194 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.