Provider Demographics
NPI:1619019536
Name:BERACAH HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BERACAH HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-487-2055
Mailing Address - Street 1:5302 JACQUELLA DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-2529
Mailing Address - Country:US
Mailing Address - Phone:318-487-2055
Mailing Address - Fax:318-487-6982
Practice Address - Street 1:5302 JACQUELLA DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-2529
Practice Address - Country:US
Practice Address - Phone:318-487-2055
Practice Address - Fax:318-487-6982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1149799Medicaid
LA1149799Medicaid