Healthcare Provider Details

I. General information

NPI: 1669656963
Provider Name (Legal Business Name): PRIORITY MEDICAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 OIL CENTER DR SUITE 105
LAFAYETTE LA
70503-2482
US

IV. Provider business mailing address

106 OIL CENTER DR SUITE 105
LAFAYETTE LA
70503-2482
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-5002
  • Fax: 337-232-5017
Mailing address:
  • Phone: 337-232-5002
  • Fax: 337-232-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7229
License Number StateLA

VIII. Authorized Official

Name: TONI FUSILIER
Title or Position: OWNER
Credential:
Phone: 337-232-5002