Provider Demographics
NPI:1770764839
Name:LINDA FOSTER
Entity type:Organization
Organization Name:LINDA FOSTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-786-3050
Mailing Address - Street 1:801 E FOURTH ST
Mailing Address - Street 2:
Mailing Address - City:DEQUINCY
Mailing Address - State:LA
Mailing Address - Zip Code:70633-3707
Mailing Address - Country:US
Mailing Address - Phone:337-786-3050
Mailing Address - Fax:337-786-3058
Practice Address - Street 1:801 E FOURTH ST
Practice Address - Street 2:
Practice Address - City:DEQUINCY
Practice Address - State:LA
Practice Address - Zip Code:70633-3707
Practice Address - Country:US
Practice Address - Phone:337-786-3050
Practice Address - Fax:337-786-3058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1179744Medicaid
LA6097620001Medicare NSC