Provider Demographics
NPI:1245633247
Name:R N G MEDICAL SUPPLIES
Entity type:Organization
Organization Name:R N G MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-438-1645
Mailing Address - Street 1:1864 FOX RUN DR
Mailing Address - Street 2:APT 2
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-6493
Mailing Address - Country:US
Mailing Address - Phone:337-438-1645
Mailing Address - Fax:
Practice Address - Street 1:1605 BROAD ST
Practice Address - Street 2:SUITE 11
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4602
Practice Address - Country:US
Practice Address - Phone:337-438-1645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3157130332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies