Healthcare Provider Details

I. General information

NPI: 1497528616
Provider Name (Legal Business Name): ALPHA CARDIOPULMONARY DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2023
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N 18TH ST
MONROE LA
71201-5780
US

IV. Provider business mailing address

204 THATCHER LN
MONROE LA
71203-6539
US

V. Phone/Fax

Practice location:
  • Phone: 318-361-9900
  • Fax:
Mailing address:
  • Phone: 318-348-1931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. BRYAN A. BRUMFIELD
Title or Position: CEO/ OWNER
Credential: RN, RVT, RRT, RDCS,
Phone: 318-348-1931