Healthcare Provider Details

I. General information

NPI: 1306426135
Provider Name (Legal Business Name): START CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CIVIC CENTER BLVD STE 136
HOUMA LA
70360-5937
US

IV. Provider business mailing address

235 CIVIC CENTER BLVD STE 136
HOUMA LA
70360-5937
US

V. Phone/Fax

Practice location:
  • Phone: 985-333-2020
  • Fax: 985-851-0162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE BROUSSARD
Title or Position: VP OF COMPLIANCE
Credential:
Phone: 985-879-3966