Provider Demographics
NPI:1902854193
Name:PROFESSIONAL BUSINESS SERVICES AND CONSULTING, INC
Entity Type:Organization
Organization Name:PROFESSIONAL BUSINESS SERVICES AND CONSULTING, INC
Other - Org Name:GULF SOUTH HOSPICE OF LOUISIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:MERRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:225-636-5145
Mailing Address - Street 1:9410 LINDALE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4160
Mailing Address - Country:US
Mailing Address - Phone:225-413-6330
Mailing Address - Fax:225-218-4339
Practice Address - Street 1:9410 LINDALE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-4160
Practice Address - Country:US
Practice Address - Phone:225-636-5145
Practice Address - Fax:225-218-4339
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL BUSINESS SERVICES AND CONSULTING, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-04
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA192251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1584738Medicaid
LA191630Medicare Oscar/Certification