NPI | 1790701340 |
---|---|
Entity Type | Organization |
Authorized Contact | KERNEY THOMAS CEO 337-363-4521 |
Organization Subpart ? | No |
Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: LA 6113) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 6581) |
Enumeration Date | 2006-07-15 |
Last Update Date | 2010-11-05 |