Provider Demographics
NPI:1306043104
Name:COMPLETE VITAL CARE
Entity Type:Organization
Organization Name:COMPLETE VITAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-473-8800
Mailing Address - Street 1:3212 INDUSTRIAL ST.
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-0000
Mailing Address - Country:US
Mailing Address - Phone:318-473-8800
Mailing Address - Fax:318-473-8005
Practice Address - Street 1:3212 INDUSTRIAL ST.
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-0000
Practice Address - Country:US
Practice Address - Phone:318-473-8800
Practice Address - Fax:318-473-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies