Healthcare Provider Details

I. General information

NPI: 1336366459
Provider Name (Legal Business Name): GM BUSINESS SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2267 HIGHWAY 3185 STE 136
THIBODAUX LA
70301-8401
US

IV. Provider business mailing address

PO BOX 5841
THIBODAUX LA
70302-5841
US

V. Phone/Fax

Practice location:
  • Phone: 985-447-4742
  • Fax:
Mailing address:
  • Phone: 985-447-4742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number9559
License Number StateLA

VIII. Authorized Official

Name: MS. GERALDINE MARSHALL
Title or Position: PRESIDENT
Credential:
Phone: 985-447-4742