OrganizationProvision Medical Suppy Llc(Provision Medical Supply)Durable Medical Equipment & Medical SuppliesSuppliersPractice Address1001 W Pinhook Rd, Suite 223a, Lafayette, LA 70503-2448(337) 504-5455PECOS EnrollmentBased on the most recent information from CMS, provider Provision Medical Suppy Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1336228535Provider TypeOrganizationFull NameProvision Medical Suppy LlcOther NameProvision Medical SupplySubpartNoEnumeration Date11/6/2006Last Updated3/10/2008Contact InformationPractice LocationPractice Address1001 W Pinhook Rd, Suite 223a, Lafayette, LA 70503-2448Phone(337) 504-5455Fax(337) 504-5456Mailing LocationMailing Address1001 W Pinhook Rd, Suite 223a, Lafayette, LA 70503-2448Phone(337) 504-5455Fax(337) 504-5456Authorized OfficialNameGivs, Marcus L (Owner)Phone(337) 504-5455Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicense3219516-001Louisiana