Provider Demographics
NPI:1831577832
Name:MOREAU MEDICAL, LLC
Entity type:Organization
Organization Name:MOREAU MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-658-2860
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791
Mailing Address - Country:US
Mailing Address - Phone:225-658-2860
Mailing Address - Fax:225-658-2861
Practice Address - Street 1:3610 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-4608
Practice Address - Country:US
Practice Address - Phone:225-658-2860
Practice Address - Fax:225-658-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies