Healthcare Provider Details

I. General information

NPI: 1518434489
Provider Name (Legal Business Name): IV SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 10/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 CAROL SUE AVE STE E
GRETNA LA
70056-5100
US

IV. Provider business mailing address

1581 CAROL SUE AVE STE E
GRETNA LA
70056-5100
US

V. Phone/Fax

Practice location:
  • Phone: 504-394-9037
  • Fax: 504-392-0973
Mailing address:
  • Phone: 504-394-9037
  • Fax: 504-392-0973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BILLY EVERETT
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 601-714-1868