Provider Demographics
NPI:1619593308
Name:PREFERENCE MEDICAL
Entity Type:Organization
Organization Name:PREFERENCE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JEANSONNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-900-4660
Mailing Address - Street 1:380 MOSS LN
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-2920
Mailing Address - Country:US
Mailing Address - Phone:985-900-4660
Mailing Address - Fax:
Practice Address - Street 1:105 BEECH ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-6214
Practice Address - Country:US
Practice Address - Phone:985-900-4676
Practice Address - Fax:985-888-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies