Healthcare Provider Details

I. General information

NPI: 1386868180
Provider Name (Legal Business Name): PROMPT SUCCOR NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 11/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

954 E PRUDHOMME ST
OPELOUSAS LA
70570-8239
US

IV. Provider business mailing address

PO BOX 13524
ALEXANDRIA LA
71315-3524
US

V. Phone/Fax

Practice location:
  • Phone: 337-948-3634
  • Fax:
Mailing address:
  • Phone: 318-445-4477
  • 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: MR. MICHAEL PURSER
Title or Position: ADMINISTRATOR
Credential:
Phone: 337-948-3634