MEDICARE: BAYOU MEDICAL 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
2	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851616809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYOU MEDICAL LLC

Provider Business Mailing Address
First Line	:	301 PRAIRIE ST
Second Line	:
City	:	WINNSBORO
State	:	LA
Zip	:	71295-2732
Country	:	US
Telephone Number	:	318-435-4140
Fax Number	:	318-435-4139

Provider Business Practice Location Address
First Line	:	301 PRAIRIE ST
Second Line	:
City	:	WINNSBORO
State	:	LA
Zip	:	71295-2732
Country	:	US
Telephone Number	:	318-435-4140
Fax Number	:	318-435-4139

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. MYRA GRAYSON
Credential	:
Telephone Number	:	318-435-4140

Provider Enumeration Date	:	04/01/2010
Last Update Date	:	12/09/2024

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Directions to “BAYOU MEDICAL LLC ” Practice Location

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