Provider Demographics
NPI:1619159662
Name:RONAN MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:RONAN MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOUCET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-484-3752
Mailing Address - Street 1:818 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-6409
Mailing Address - Country:US
Mailing Address - Phone:318-484-3752
Mailing Address - Fax:
Practice Address - Street 1:818 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-6409
Practice Address - Country:US
Practice Address - Phone:318-484-3752
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-01
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6121990001Medicare NSC