Healthcare Provider Details

I. General information

NPI: 1811172463
Provider Name (Legal Business Name): BODY PARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 LOUISIANA AVE
BOGALUSA LA
70427-3329
US

IV. Provider business mailing address

722 LOUISIANA AVE
BOGALUSA LA
70427-3329
US

V. Phone/Fax

Practice location:
  • Phone: 985-730-4357
  • Fax: 985-730-5267
Mailing address:
  • Phone: 985-730-4357
  • Fax: 985-730-5267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN SCOTT CAMPBELL SR.
Title or Position: CEO
Credential:
Phone: 985-730-4357