1235343872 NPI number — FROST EQUIPMENT & SUPPLIES INC

Table of content: WAYNE A. MARLOWE M.D. (NPI 1619900677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235343872 NPI number — FROST EQUIPMENT & SUPPLIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FROST EQUIPMENT & SUPPLIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235343872
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7505 PINES ROAD
Provider Second Line Business Mailing Address:
SUITE 1255
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71129-3923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-687-9929
Provider Business Mailing Address Fax Number:
318-687-9469

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7505 PINES ROAD
Provider Second Line Business Practice Location Address:
SUITE 1255
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71129-3923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-687-9929
Provider Business Practice Location Address Fax Number:
318-687-9469
Provider Enumeration Date:
05/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JAMISON
Authorized Official First Name:
JESSICA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
318-687-9929

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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