MEDICARE: PRECIOUS GEMS, INC

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
1	251G00000X	Community Based Hospice Care Agency		LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659696094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECIOUS GEMS, INC

Provider Business Mailing Address
First Line	:	9420 LINDALE AVE
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-4161
Country	:	US
Telephone Number	:	225-810-4446
Fax Number	:	225-810-4448

Provider Business Practice Location Address
First Line	:	9420 LINDALE AVE
Second Line	:	SUITE A
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-4161
Country	:	US
Telephone Number	:	225-810-4446
Fax Number	:	225-810-4448

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. MARGIE D JENKINS
Credential	:
Telephone Number	:	225-810-4446

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	03/29/2010

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