MEDICARE: SOILEAU'S VITAL CARE, INC.

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	2491-IR	LA
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	2491-IR	LA
3	333600000X	Pharmacy	2491-IR	LA
4	3336C0003X	Community/Retail Pharmacy	2491-IR	LA
5	3336H0001X	Home Infusion Therapy Pharmacy	2491-IR	LA
6	3336L0003X	Long Term Care Pharmacy	2491-IR	LA
7	3336M0002X	Mail Order Pharmacy	2491-IR	LA
8	3336S0011X	Specialty Pharmacy	2491-IR	LA
9	251F00000X	Home Infusion Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5DM88	OTHER	LA	LOCAL MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	167677	OTHER	PA	BCBS

General Provider Information

NPI Number	:	1619992427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOILEAU'S VITAL CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 5047
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39302-5047
Country	:	US
Telephone Number	:	800-447-4095
Fax Number	:	601-482-7490

Provider Business Practice Location Address
First Line	:	7612 PICARDY AVE
Second Line	:	STE B
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4353
Country	:	US
Telephone Number	:	225-766-7453
Fax Number	:	225-766-9293

Authorized Official
Title or Position	:	OWNER/SECRETARY
Name	:	MELANIE H CLARK
Credential	:
Telephone Number	:	225-766-7453

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	07/21/2025

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