Provider Demographics
NPI:1477393734
Name:INDEED MEDICAL MOBILE LAB LLC
Entity type:Organization
Organization Name:INDEED MEDICAL MOBILE LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PASCOL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-314-9501
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70589-0456
Mailing Address - Country:US
Mailing Address - Phone:337-314-9501
Mailing Address - Fax:
Practice Address - Street 1:3419 NW EVANGELINE TRWY STE 8
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6241
Practice Address - Country:US
Practice Address - Phone:337-314-9501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty