South Shreve Medical Supplies, Inc.

Primary specialty

Nursing Facility Supplies (DME)Taxonomy code 332BN1400X

Legal business name

SOUTH SHREVE MEDICAL SUPPLIES, INC.

Practice address

8520 Business Park Dr
Shreveport, LA 71105-5654

Phone

(318) 798-2648

Fax

(318) 798-3451

NPI assigned

Jan 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles D Macey, CPA

Title

Controller

Phone

(318) 798-2648

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619028917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52389",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711352389",
            "telephone_number": "318-798-2648",
            "fax_number": "318-798-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8520 BUSINESS PARK DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055654",
            "telephone_number": "318-798-2648",
            "fax_number": "318-798-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHREVE MEDICAL SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "318-798-2648",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Lynn Sorrells Jr., MD
• Kelli Sorrells, PHARM.D.
• Carolina Soto-Davila
• Kenya Leigh Soto, CCC SLP
• John Caleist Soud, DO
• South Shreveport Anesthesia
• South Shreveport Family Medicine, LLC
• South Shreveport Internal Medicine
• Southern Hills LLC (Southern Hills Healthcare & Rehabilitation)
• Southern Kidney Associates PLLC

• Nursing Facility Supplies (DME) in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Nursing Facility Supplies (DME) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.