Provider Demographics
NPI:1417079476
Name:PCA NURSING SERVICES OF BATON ROUGE
Entity Type:Organization
Organization Name:PCA NURSING SERVICES OF BATON ROUGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:225-346-4000
Mailing Address - Street 1:1779 GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-4057
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1779 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-4057
Practice Address - Country:US
Practice Address - Phone:225-346-4000
Practice Address - Fax:225-346-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12206251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1787345Medicaid
LA1591670Medicaid