Provider Demographics
NPI:1407000623
Name:BAYOU MEDICAL CARE
Entity Type:Organization
Organization Name:BAYOU MEDICAL CARE
Other - Org Name:1ST CALL DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-367-0029
Mailing Address - Street 1:1799 STUMPF BLVD
Mailing Address - Street 2:BLDG 7 SUITE 8
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2596
Mailing Address - Country:US
Mailing Address - Phone:504-367-0029
Mailing Address - Fax:504-367-0014
Practice Address - Street 1:1799 STUMPF BLVD
Practice Address - Street 2:BLDG 7 SUITE 8
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2596
Practice Address - Country:US
Practice Address - Phone:504-367-0029
Practice Address - Fax:504-367-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1444456Medicare Oscar/Certification