Healthcare Provider Details

I. General information

NPI: 1346166675
Provider Name (Legal Business Name): NUTRICAREUSA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3259 LAKE CREST DR STE 100
LAKE CHARLES LA
70607-4302
US

IV. Provider business mailing address

3259 LAKE CREST DR STE 100
LAKE CHARLES LA
70607-4302
US

V. Phone/Fax

Practice location:
  • Phone: 337-884-0462
  • Fax: 337-884-0462
Mailing address:
  • Phone: 337-884-0462
  • Fax: 337-884-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: JACQUE ROMERO
Title or Position: OWNER
Credential:
Phone: 337-884-0462