Provider Demographics
NPI:1023017985
Name:BEST BUY HOMECARE OF LOUISIANA, INC
Entity Type:Organization
Organization Name:BEST BUY HOMECARE OF LOUISIANA, INC
Other - Org Name:BEST BUY HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-754-4527
Mailing Address - Street 1:112 STEAMBOAT BEND SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-2867
Mailing Address - Country:US
Mailing Address - Phone:573-221-5732
Mailing Address - Fax:573-221-5762
Practice Address - Street 1:112 STEAMBOAT BEND SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-2867
Practice Address - Country:US
Practice Address - Phone:573-221-5732
Practice Address - Fax:573-221-5762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
V0170OtherHOMELINK
106481OtherBLUE CROSS BLUE SHIELD
81717OtherNORTHWOOD (NPN)
228220OtherHEALTHLINK
8205005OtherUNITED HEALTHCARE
8205005OtherUNITED HEALTHCARE
IL=========01Medicaid
IL=========01Medicaid