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NPI Code Detail

MEDICARE: PROMPT SUCCOR NURSING HOME

MEDICARE: PROMPT SUCCOR NURSING HOME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
230087OTHERLABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1386868180
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROMPT SUCCOR NURSING HOME
Provider Business Mailing Address
First Line : PO BOX 13524
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71315-3524
Country : US
Telephone Number : 318-445-4477
Fax Number :
Provider Business Practice Location Address
First Line : 954 E PRUDHOMME ST
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-8239
Country : US
Telephone Number : 337-948-3634
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. MICHAEL PURSER
Credential :
Telephone Number : 337-948-3634
Provider Enumeration Date : 04/12/2007
Last Update Date : 11/14/2008

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Directions to “PROMPT SUCCOR NURSING HOME ” Practice Location

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