Healthcare Provider Details

I. General information

NPI: 1720257967
Provider Name (Legal Business Name): PASSIONS MEDICAL TEAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 LANDRUM ST
MELVILLE LA
71353
US

IV. Provider business mailing address

PO BOX 838
MELVILLE LA
71353-0838
US

V. Phone/Fax

Practice location:
  • Phone: 337-623-0305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. FRANCIES JONES-HAYWARD
Title or Position: MANAGER
Credential:
Phone: 337-623-0305