Healthcare Provider Details

I. General information

NPI: 1356906911
Provider Name (Legal Business Name): ALLIED MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 05/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 BAYOU TORTUE, RD SUITE 1
BROUSSARD LA
70518
US

IV. Provider business mailing address

P.O. BOX 1047
BROUSSARD LA
70518
US

V. Phone/Fax

Practice location:
  • Phone: 337-837-4049
  • Fax: 337-837-6665
Mailing address:
  • Phone: 337-837-4049
  • Fax: 337-837-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: CURLIS T SAVOY
Title or Position: ADMINISTRATOR
Credential:
Phone: 337-837-4049