Healthcare Provider Details

I. General information

NPI: 1710285085
Provider Name (Legal Business Name): TARC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2011
Last Update Date: 03/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N CYPRESS ST
HAMMOND LA
70401-2641
US

IV. Provider business mailing address

408 NORTH CYPRESS STREET
HAMMOND LA
70401
US

V. Phone/Fax

Practice location:
  • Phone: 985-549-0712
  • Fax: 985-549-0743
Mailing address:
  • Phone: 985-549-0712
  • Fax: 985-549-0743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN ABELS
Title or Position: CEO
Credential:
Phone: 985-549-0712