Healthcare Provider Details

I. General information

NPI: 1457130635
Provider Name (Legal Business Name): THE QUAD USA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 E SAINT MARY BLVD STE A
LAFAYETTE LA
70503-2347
US

IV. Provider business mailing address

1021 E SAINT MARY BLVD STE A
LAFAYETTE LA
70503-2347
US

V. Phone/Fax

Practice location:
  • Phone: 337-999-7823
  • Fax:
Mailing address:
  • Phone: 337-999-7823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAROLINE JURISICH
Title or Position: OWNER
Credential: ED.D.
Phone: 318-572-5222