Provider Demographics
NPI:1144421751
Name:CARDINAL HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:CARDINAL HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-291-3322
Mailing Address - Street 1:8280 YMCA PLAZA DR
Mailing Address - Street 2:BUILDING 3 SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-0927
Mailing Address - Country:US
Mailing Address - Phone:225-291-3322
Mailing Address - Fax:225-291-3311
Practice Address - Street 1:8280 YMCA PLAZA DR
Practice Address - Street 2:BUILDING 3 SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810
Practice Address - Country:US
Practice Address - Phone:225-291-3322
Practice Address - Fax:225-291-3311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1023931Medicaid
LA191645Medicare Oscar/Certification