Provider Demographics
NPI:1720256662
Name:VASOCARE LLC
Entity Type:Organization
Organization Name:VASOCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BERGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-924-0444
Mailing Address - Street 1:PO BOX 14933
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70898-4933
Mailing Address - Country:US
Mailing Address - Phone:225-924-0444
Mailing Address - Fax:866-455-5150
Practice Address - Street 1:6554 FLORIDA BLVD
Practice Address - Street 2:SUITE 123
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4474
Practice Address - Country:US
Practice Address - Phone:225-924-0444
Practice Address - Fax:866-455-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1372676Medicaid
LA=========0OtherBCBS OF LA
LA6106920001Medicare NSC