Provider Demographics
NPI:1700924768
Name:THE MEDICAL TEAM, INC.
Entity type:Organization
Organization Name:THE MEDICAL TEAM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DCO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMPAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:985-872-6666
Mailing Address - Street 1:4722 HIGHWAY 311
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2865
Mailing Address - Country:US
Mailing Address - Phone:985-872-6666
Mailing Address - Fax:985-872-3263
Practice Address - Street 1:3445 N CAUSEWAY BLVD STE 904
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3767
Practice Address - Country:US
Practice Address - Phone:985-872-6666
Practice Address - Fax:985-872-3263
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MEDICAL TEAM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-02
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA69251E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1403121Medicaid
LA1403121Medicaid