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General NPI Number Information
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NPI Number | 1932409521
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Entity Type | Organization
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Legal Business Name | INTRATHECAL CARE SERVICES OF LOUISIANA LLC
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Dates
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Enumeration Date | 10/28/2010
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Last Update Date | 02/08/2026
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Provider Practice Location Address
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Address Line | 228 N PARKERSON AVE
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City | CROWLEY
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State | LA
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Zip | 70526-5003
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Country | US
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Telephone | 337-783-5010
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Fax | 651-436-0399
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Provider Business Mailing Address
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Address Line | PO BOX 612
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City | CROWLEY
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State | LA
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Zip | 70527-0612
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Country | US
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Telephone | 337-783-5010
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Fax | 651-436-0399
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Authorized Official
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Title or Position | MANAGER
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Name | KAYLA WASHINGTON
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Credential | MANAGER
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Telephone | 337-783-5010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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