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NPI Code Detail

MEDICARE: ANDREW ROBERTS BS

MEDICARE:   ANDREW  ROBERTS  BS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1407798937
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW ROBERTS BS
Provider Business Mailing Address
First Line : 1418 TIGER DR
Second Line :
City : THIBODAUX
State : LA
Zip : 70301-4337
Country : US
Telephone Number : 985-449-4055
Fax Number : 985-449-4178
Provider Business Practice Location Address
First Line : 1418 TIGER DR
Second Line :
City : THIBODAUX
State : LA
Zip : 70301-4337
Country : US
Telephone Number : 985-449-4055
Fax Number : 985-449-4178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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