Provider Demographics
NPI:1336449305
Name:GLOVE, INCORPORATED
Entity Type:Organization
Organization Name:GLOVE, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOUDY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:337-363-4758
Mailing Address - Street 1:802 N DUPRE ST # 34
Mailing Address - Street 2:P.O. BOX 2051
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-3071
Mailing Address - Country:US
Mailing Address - Phone:337-363-4758
Mailing Address - Fax:337-363-4760
Practice Address - Street 1:802 N DUPRE ST # 34
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-3071
Practice Address - Country:US
Practice Address - Phone:337-363-4758
Practice Address - Fax:337-363-4760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA42Medicaid
LA68Medicaid