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NPI Code Detail

MEDICARE: OUR LADY OF PROMPT SUCCOR

MEDICARE: OUR LADY OF PROMPT SUCCOR
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
1313M00000XNursing Facility/Intermediate Care Facility226LA

Other Identifiers

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

General Provider Information

NPI Number : 1912189036
Entity Type Code : Organization
Provider Name (Legal Business Name) : OUR LADY OF PROMPT SUCCOR
Provider Business Mailing Address
First Line : 954 E PRUDHOMME ST
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-8239
Country : US
Telephone Number : 337-948-3634
Fax Number : 337-942-8279
Provider Business Practice Location Address
First Line : 954 E PRUDHOMME ST
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-8239
Country : US
Telephone Number : 337-948-3634
Fax Number : 337-942-8279
Authorized Official
Title or Position : ADMINSTRATOR
Name : MR. MICHAEL PURSER
Credential :
Telephone Number : 337-948-3634
Provider Enumeration Date : 11/30/2007
Last Update Date : 11/30/2007

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Directions to “OUR LADY OF PROMPT SUCCOR ” Practice Location

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