Provider Demographics
NPI:1811172463
Name:BODY PARTS LLC
Entity type:Organization
Organization Name:BODY PARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:985-730-4357
Mailing Address - Street 1:722 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3329
Mailing Address - Country:US
Mailing Address - Phone:985-730-4357
Mailing Address - Fax:985-730-5267
Practice Address - Street 1:722 LOUISIANA AVE
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3329
Practice Address - Country:US
Practice Address - Phone:985-730-4357
Practice Address - Fax:985-730-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1561312Medicaid
MS00440994Medicaid
LA=========0OtherBLUE CROSS
LA1269340001Medicare NSC