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General NPI Number Information
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NPI Number | 1184586463
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Entity Type | Organization
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Legal Business Name | FORGET ME NOT MEDICAL SERVICES LLC 2
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 221 RIDGEWAY ST
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City | THIBODAUX
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State | LA
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Zip | 70301-5127
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Country | US
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Telephone | 225-316-3623
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Fax |
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Provider Business Mailing Address
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Address Line | 39139 OLD BAYOU AVE
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City | GONZALES
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State | LA
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Zip | 70737-6292
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Country | US
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Telephone | 225-316-3623
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SHARDAY THOMAS
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Credential |
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Telephone | 225-316-3623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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