Provider Demographics
NPI:1205048493
Name:EXCELLENT MEDICAL SUPPLY AND EQUIPMENT
Entity type:Organization
Organization Name:EXCELLENT MEDICAL SUPPLY AND EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:RENNA
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-368-9191
Mailing Address - Street 1:1799 STUMPF BLVD.
Mailing Address - Street 2:BUILDING 7 SUITE 8
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056
Mailing Address - Country:US
Mailing Address - Phone:504-368-9191
Mailing Address - Fax:504-368-9192
Practice Address - Street 1:1799 STUMPF BLVD.
Practice Address - Street 2:BUILDING 7 SUITE 8
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056
Practice Address - Country:US
Practice Address - Phone:504-368-9191
Practice Address - Fax:504-368-9192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies