Provider Demographics
NPI:1043205446
Name:PRIMARY OCCUPATIONAL HEALTH SERVICES, L.L.C.
Entity Type:Organization
Organization Name:PRIMARY OCCUPATIONAL HEALTH SERVICES, L.L.C.
Other - Org Name:LAFOURCHE SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DEVELOPMENT MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-475-6555
Mailing Address - Street 1:2510 N ALEX PLAISANCE BLVD
Mailing Address - Street 2:
Mailing Address - City:GOLDEN MEADOW
Mailing Address - State:LA
Mailing Address - Zip Code:70357-2351
Mailing Address - Country:US
Mailing Address - Phone:985-475-6555
Mailing Address - Fax:985-475-8643
Practice Address - Street 1:2510 N ALEX PLAISANCE BLVD
Practice Address - Street 2:
Practice Address - City:GOLDEN MEADOW
Practice Address - State:LA
Practice Address - Zip Code:70357-2351
Practice Address - Country:US
Practice Address - Phone:985-475-6555
Practice Address - Fax:985-475-8643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine