MEDICARE: SIGNIFICANT HEALTHCARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		LA

General Provider Information

NPI Number	:	1235436890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIGNIFICANT HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	1724 DALLAS DR
Second Line	:	SUITE 3
City	:	BATON ROUGE
State	:	LA
Zip	:	70806
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1724 DALLAS DR
Second Line	:	SUITE 3
City	:	BATON ROUGE
State	:	LA
Zip	:	70806
Country	:	US
Telephone Number	:	225-930-7575
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. STEPHANIE JOHNSON
Credential	:
Telephone Number	:	225-930-7575

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	02/17/2011

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