Healthcare Provider Details

I. General information

NPI: 1952578015
Provider Name (Legal Business Name): COTTLES PCS SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 SOUTH DR
NATCHITOCHES LA
71457-5060
US

IV. Provider business mailing address

329 SOUTH DR
NATCHITOCHES LA
71457-5060
US

V. Phone/Fax

Practice location:
  • Phone: 318-238-5900
  • Fax: 318-238-5901
Mailing address:
  • Phone: 318-238-5900
  • Fax: 318-238-5901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateLA

VIII. Authorized Official

Name: DR. CHERILYNNE TONI COTTLES
Title or Position: OWNER
Credential: MD
Phone: 318-238-5900