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General NPI Number Information
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NPI Number | 1427456045
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Entity Type | Organization
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Legal Business Name | BUSBY HOLDINGS LLC
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Dates
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Enumeration Date | 12/12/2014
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Last Update Date | 12/12/2014
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Provider Practice Location Address
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Address Line | 815 SEDONA PINES DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-5548
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Country | US
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Telephone | 614-619-7925
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Fax |
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Provider Business Mailing Address
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Address Line | 815 SEDONA PINES DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-5548
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Country | US
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Telephone | 614-619-7925
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA BUSBY
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Credential |
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Telephone | 614-619-7925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | LA
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