Healthcare Provider Details

I. General information

NPI: 1588793475
Provider Name (Legal Business Name): GLOBAL DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 S BUCHANAN ST SUITE A
LAFAYETTE LA
70501-6820
US

IV. Provider business mailing address

718 S BUCHANAN ST SUITE A
LAFAYETTE LA
70501-6820
US

V. Phone/Fax

Practice location:
  • Phone: 337-289-0882
  • Fax: 337-289-0304
Mailing address:
  • Phone: 337-289-0882
  • Fax: 337-289-0304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHARLENE PIKE BOUDREAUX
Title or Position: OFFICE MANAGER
Credential:
Phone: 337-289-0882