Healthcare Provider Details

I. General information

NPI: 1053796565
Provider Name (Legal Business Name): HEALTHREMEDE ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2015
Last Update Date: 07/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8742 GOODWOOD BLVD
BATON ROUGE LA
70806-7915
US

IV. Provider business mailing address

8742 GOODWOOD BLVD
BATON ROUGE LA
70806-7915
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-3030
  • Fax: 225-387-4521
Mailing address:
  • Phone: 225-387-3030
  • Fax: 225-387-4521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number StateLA

VIII. Authorized Official

Name: BRAD W FRICK
Title or Position: MANAGING MEMBER
Credential: PA-C
Phone: 225-387-3030