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General NPI Number Information
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NPI Number | 1619019536
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Entity Type | Organization
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Legal Business Name | BERACAH HEALTHCARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5302 JACQUELLA DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-2529
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Country | US
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Telephone | 318-487-2055
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Fax | 318-487-6982
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Provider Business Mailing Address
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Address Line | 5302 JACQUELLA DR
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City | ALEXANDRIA
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State | LA
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Zip | 71301-2529
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Country | US
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Telephone | 318-487-2055
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Fax | 318-487-6982
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Authorized Official
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Title or Position | OWNER-OFFICER
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Name | MRS. GLORIA CUTTS
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Credential |
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Telephone | 318-487-2055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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