Healthcare Provider Details

I. General information

NPI: 1295941243
Provider Name (Legal Business Name): COMPLETE PATIENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 04/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70161 HIGHWAY 59 SUITE C
ABITA SPRINGS LA
70420-3706
US

IV. Provider business mailing address

70161 HIGHWAY 59 SUITE C
ABITA SPRINGS LA
70420-3706
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-7775
  • Fax: 985-892-4230
Mailing address:
  • Phone: 985-892-7775
  • Fax: 985-892-4230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number89101288
License Number StateLA

VIII. Authorized Official

Name: MRS. DEBRA G STOUDENMIRE
Title or Position: OWNER
Credential:
Phone: 251-460-0300