Provider Demographics
NPI:1770799363
Name:ROLLINS HOME MEDICAL,LLC DBA MED FIRST MEDICALMEDICAL
Entity type:Organization
Organization Name:ROLLINS HOME MEDICAL,LLC DBA MED FIRST MEDICALMEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-483-1838
Mailing Address - Street 1:1401 TEXAS AVE
Mailing Address - Street 2:SUITE C-D
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-4048
Mailing Address - Country:US
Mailing Address - Phone:318-483-1838
Mailing Address - Fax:318-442-4234
Practice Address - Street 1:1401 TEXAS AVE
Practice Address - Street 2:SUITE C-D
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-4048
Practice Address - Country:US
Practice Address - Phone:318-483-1838
Practice Address - Fax:318-442-4234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization