Provider Demographics
NPI:1639552334
Name:PREVENTIVE COMPLIANCE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PREVENTIVE COMPLIANCE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT - CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRASHANT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-551-4946
Mailing Address - Street 1:1012 PETROLEUM PKWY
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-8020
Mailing Address - Country:US
Mailing Address - Phone:337-551-4946
Mailing Address - Fax:337-551-4948
Practice Address - Street 1:1012 PETROLEUM PKWY
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-8020
Practice Address - Country:US
Practice Address - Phone:337-551-4946
Practice Address - Fax:337-551-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2017822083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty