| NPI | 1336228535 |
|---|---|
| Former Legal Business Name | PROVISION MEDICAL SUPPLY |
| Entity Type | Organization |
| Authorized Contact | MARCUS L GIVS Owner 337-504-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 3219516-001) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-03-10 |