Healthcare Provider Details

I. General information

NPI: 1558194985
Provider Name (Legal Business Name): VIEMED CLINICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 DARCY DR
ARCHER LODGE NC
27527-7309
US

IV. Provider business mailing address

625 E KALISTE SALOOM RD STE 400N
LAFAYETTE LA
70508-2540
US

V. Phone/Fax

Practice location:
  • Phone: 337-504-3802
  • Fax: 337-504-4409
Mailing address:
  • Phone: 337-504-3802
  • Fax: 337-504-4409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RYAN SULLIVAN
Title or Position: EVP
Credential:
Phone: 337-504-3802