Provider Demographics
NPI:1376750950
Name:GULF SOUTH ANIMATED MOTION TECHNOLOGIES
Entity Type:Organization
Organization Name:GULF SOUTH ANIMATED MOTION TECHNOLOGIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WOODROW
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:225-925-2468
Mailing Address - Street 1:3053B OLD FORGE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3150
Mailing Address - Country:US
Mailing Address - Phone:225-925-2468
Mailing Address - Fax:225-924-9070
Practice Address - Street 1:3053B OLD FORGE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3150
Practice Address - Country:US
Practice Address - Phone:225-925-2468
Practice Address - Fax:225-924-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3363074001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies