| Organization Name: | JEFF DAVIS MEDICAL SUPPLIES, LLC |
| NPI Number: | 1073676714 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTEL DOUCET (BUSINESS OFFICE MANGER) |
| Mailing Address: | 1338 N Cutting Ave Jennings |
| State: | LA US |
| Postal Code: | 705464202 |
| Phone Number: | 3378243165 |
| Fax Number: | 3378243183 |
| NPI Enumeration Date: | 12/17/2006 |
| NPI Last Update Date: | 12/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BN1400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | LA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Nursing Facility Supplies |
| Taxonomy Definition: | |