Provider Demographics
NPI:1659548436
Name:COTTLES PCS SERVICES
Entity Type:Organization
Organization Name:COTTLES PCS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERILYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-238-5900
Mailing Address - Street 1:329 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5060
Mailing Address - Country:US
Mailing Address - Phone:318-238-5900
Mailing Address - Fax:318-238-5901
Practice Address - Street 1:329 SOUTH DR
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5060
Practice Address - Country:US
Practice Address - Phone:318-238-5900
Practice Address - Fax:318-238-5901
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHERILYNNE T COTTLESMD,MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251E00000X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory