MEDICARE: COMPLETE VITAL CARE

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

General Provider Information

NPI Number	:	1306043104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE VITAL CARE

Provider Business Mailing Address
First Line	:	3212 INDUSTRIAL ST.
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-0000
Country	:	US
Telephone Number	:	318-473-8800
Fax Number	:	318-473-8005

Provider Business Practice Location Address
First Line	:	3212 INDUSTRIAL ST.
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-0000
Country	:	US
Telephone Number	:	318-473-8800
Fax Number	:	318-473-8005

Authorized Official
Title or Position	:	BILLING
Name	:	ALENA BREWER
Credential	:
Telephone Number	:	318-473-8800

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	08/22/2020

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Directions to “COMPLETE VITAL CARE ” Practice Location

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