Healthcare Provider Details

I. General information

NPI: 1073569067
Provider Name (Legal Business Name): EGAN HEALTHCARE OF PLAQUEMINES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W COMMERCE RD STE 500
HARAHAN LA
70123-3330
US

IV. Provider business mailing address

PO BOX 51266
LAFAYETTE LA
70505-1266
US

V. Phone/Fax

Practice location:
  • Phone: 504-835-4474
  • Fax: 504-832-3292
Mailing address:
  • Phone: 337-233-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number909
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA L. PROFFIT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307