Healthcare Provider Details

I. General information

NPI: 1235759275
Provider Name (Legal Business Name): VIEMED CLINICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2020
Last Update Date: 04/19/2024
Certification Date: 04/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 E KALISTE SALOOM RD STE 400-N
LAFAYETTE LA
70508-2540
US

IV. Provider business mailing address

625 E KALISTE SALOOM RD STE 400-N
LAFAYETTE LA
70508-2540
US

V. Phone/Fax

Practice location:
  • Phone: 337-504-3802
  • Fax: 337-504-4409
Mailing address:
  • Phone: 833-452-0220
  • Fax: 800-398-9547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RYAN GARRETT SULLIVAN
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 337-255-7438