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NPI Code Detail

MEDICARE: BIO-MEDICAL APPLICATIONS OF LOUISIANA, LLC

MEDICARE: BIO-MEDICAL APPLICATIONS OF LOUISIANA, 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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1538604798
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIO-MEDICAL APPLICATIONS OF LOUISIANA, LLC
Provider Business Mailing Address
First Line : 3214 VENTURE PARK DR
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70615-5443
Country : US
Telephone Number : 337-478-4846
Fax Number : 337-478-4849
Provider Business Practice Location Address
First Line : 3214 VENTURE PARK DR
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70615-5443
Country : US
Telephone Number : 337-478-4846
Fax Number : 337-478-4849
Authorized Official
Title or Position : VICE PRESIDENT
Name : BARRY L. BLANTON
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 12/27/2016
Last Update Date : 10/20/2023

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