Provider Demographics
NPI:1366440695
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 1:3426 GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:LOUISIANA
Mailing Address - State:MO
Mailing Address - Zip Code:63353-2743
Mailing Address - Country:US
Mailing Address - Phone:573-754-4527
Mailing Address - Fax:573-754-4529
Practice Address - Street 1:3426 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:LOUISIANA
Practice Address - State:MO
Practice Address - Zip Code:63353-2743
Practice Address - Country:US
Practice Address - Phone:573-754-4527
Practice Address - Fax:573-754-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332B00000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
8205005OtherUNITED HEALTHCARE
106481OtherBLUE CROSS BLUE SHIELD
MOV0167OtherHOMELINK
MO81714OtherNORTHWOOD (NPN)
228220OtherHEALTHLINK
MO81714OtherNORTHWOOD (NPN)
8205005OtherUNITED HEALTHCARE