Provider Demographics
NPI:1245443886
Name:SHEILA D RAY
Entity type:Organization
Organization Name:SHEILA D RAY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-942-3544
Mailing Address - Street 1:1202 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-7712
Mailing Address - Country:US
Mailing Address - Phone:337-942-3544
Mailing Address - Fax:337-942-3544
Practice Address - Street 1:1202 HEATHER DR
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-7712
Practice Address - Country:US
Practice Address - Phone:337-942-3544
Practice Address - Fax:337-942-3544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1903965Medicaid
LA8290011OtherUNITED HEALTH CARE OF LA.
LAF2486OtherBLUE CROSS
LA1903965Medicaid