MEDICARE: ST PAUL COMPANION CARE LLC

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	251E00000X	Home Health Agency	PCA7221	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	:	1821254228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST PAUL COMPANION CARE LLC

Provider Business Mailing Address
First Line	:	1 LAKESHORE DR STE 1695
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70629-0124
Country	:	US
Telephone Number	:	337-433-0100
Fax Number	:	337-433-1940

Provider Business Practice Location Address
First Line	:	1 LAKESHORE DR STE 1695
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70629-0124
Country	:	US
Telephone Number	:	337-433-0100
Fax Number	:	337-433-1940

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. YUL DUBART LORIO
Credential	:
Telephone Number	:	337-433-0100

Provider Enumeration Date	:	08/05/2008
Last Update Date	:	08/05/2008

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Directions to “ST PAUL COMPANION CARE LLC ” Practice Location

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