Healthcare Provider Details

I. General information

NPI: 1457320343
Provider Name (Legal Business Name): P P S I OF VILLE PLATTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409A E LINCOLN RD
VILLE PLATTE LA
70586-3431
US

IV. Provider business mailing address

409A E LINCOLN RD
VILLE PLATTE LA
70586-3431
US

V. Phone/Fax

Practice location:
  • Phone: 337-363-2183
  • Fax: 337-363-2187
Mailing address:
  • Phone: 337-363-2183
  • Fax: 337-363-2187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2536-IR
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number2536-IR
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2536-IR
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number2536-IR
License Number StateLA

VIII. Authorized Official

Name: MR. JAMES G SOILEAU
Title or Position: OWNER
Credential:
Phone: 337-363-2183