Provider Demographics
NPI:1831264803
Name:HORIZON MEDICAL AND NURSING SUPPLY, LLC
Entity type:Organization
Organization Name:HORIZON MEDICAL AND NURSING SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:COREY
Authorized Official - Middle Name:
Authorized Official - Last Name:VIZINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-824-9370
Mailing Address - Street 1:422 NORTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546
Mailing Address - Country:US
Mailing Address - Phone:337-824-9370
Mailing Address - Fax:337-824-9275
Practice Address - Street 1:422 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-5344
Practice Address - Country:US
Practice Address - Phone:337-824-9370
Practice Address - Fax:337-824-9275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0000003761332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5425300001Medicare ID - Type Unspecified