MEDICARE: COMPANION CARE OF SOUTHWEST LOUISIANA

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	253Z00000X	In Home Supportive Care Agency	15351	LA

General Provider Information

NPI Number	:	1922505783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPANION CARE OF SOUTHWEST LOUISIANA

Provider Business Mailing Address
First Line	:	1014A N PINE ST
Second Line	:
City	:	DERIDDER
State	:	LA
Zip	:	70634-2818
Country	:	US
Telephone Number	:	337-463-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	1014A N PINE ST
Second Line	:
City	:	DERIDDER
State	:	LA
Zip	:	70634-2818
Country	:	US
Telephone Number	:	337-463-3550
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARK WALLACE
Credential	:
Telephone Number	:	337-463-3550

Provider Enumeration Date	:	04/09/2018
Last Update Date	:	04/09/2018

Similar Medicare Providers

1912714965 — JOSHUA LAYNE CAIN
Practice Location Address:

1014 N PINE ST STE A
DERIDDER, LA
70634-2818

Practice Phone: 337-463-4020
Practice Fax:

1467788976 — COMPANION CARE OF SWLA
Practice Location Address:

1014 N PINE ST
DERIDDER, LA
70634-2818

Practice Phone: 337-463-3550
Practice Fax: 337-462-8012

1316264575 — COMPANION CARE OF SWLA
Practice Location Address:

1014A N PINE ST
DERIDDER, LA
70634-2818

Practice Phone: 337-463-3550
Practice Fax: 337-463-8012

1679843098 — BEAUREGARD MEDICAL SUPPLY LLC
Practice Location Address:

1004 N PINE ST , B
DERIDDER, LA
70634-2818

Practice Phone: 337-842-6142
Practice Fax:

1962946731 — MISTY CRESSIONNIE CSW, MSW
Practice Location Address:

1014 N PINE ST STE A
DERIDDER, LA
70634-2818

Practice Phone: 337-463-4020
Practice Fax: 337-463-4033

1609527738 — T'ENAYA DOW
Practice Location Address:

1014 N PINE ST
DERIDDER, LA
70634-2818

Practice Phone: 337-463-4020
Practice Fax:

Directions to “COMPANION CARE OF SOUTHWEST LOUISIANA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.