Provider Demographics
NPI:1487854949
Name:GASTROENTEROLOGY CLINIC OF ACADIANA
Entity Type:Organization
Organization Name:GASTROENTEROLOGY CLINIC OF ACADIANA
Other - Org Name:GCA INFUSION AND PHARMACEUTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ABSHIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-232-6697
Mailing Address - Street 1:PO BOX 51125
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1125
Mailing Address - Country:US
Mailing Address - Phone:337-232-6697
Mailing Address - Fax:337-232-3147
Practice Address - Street 1:1211 COOLIDGE BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2636
Practice Address - Country:US
Practice Address - Phone:337-232-6697
Practice Address - Fax:337-232-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CW72Medicare PIN