MEDICARE: RECOVERCARE, 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	3222775-001	LA

General Provider Information

NPI Number	:	1770737470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECOVERCARE, LLC.

Provider Business Mailing Address
First Line	:	1920 STANLEY GAULT PKWY
Second Line	:	STE 100
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-4208
Country	:	US
Telephone Number	:	502-489-9449
Fax Number	:	502-489-9401

Provider Business Practice Location Address
First Line	:	4602A MACKS DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-5326
Country	:	US
Telephone Number	:	888-750-7828
Fax Number	:	318-747-2522

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. MARY S ZAPPONE
Credential	:
Telephone Number	:	502-489-9449

Provider Enumeration Date	:	11/07/2008
Last Update Date	:	07/09/2014

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