ACADIANA WOUND CLINIC LLC (NPI# 1306102884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306102884 |
Entity Type | Organization |
Organization Name | ACADIANA WOUND CLINIC LLC |
Other Organization Name | ACADIANA WOUND & SPECIALTY SERVICES LLC |
Practice Address |
850 N Pierce St Suite C Lafayette LA 70501-2848 |
Mailing Address |
850 N Pierce St Lafayette LA 70501-2848 |
Practice Telephone | 3378738898 |
Mailing Telephone | 3378738898 |
Enumeration Date | 2012-04-09 |
Last Update Date | 2012-04-09 |
Authorized Official Name | MELANIE A GORDON (OWNER) |
Authorized Official Telephone | 3378738898 |
Authorized Official Credential | RN WCC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
LA | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
acadiana wound & specialty services llc | Doing Business As Name - Organization |
Street Address |
850 N PIERCE ST SUITE C |
City | LAFAYETTE |
State | LA |
Zip Code | 70501-2848 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710975487 | James M. Mwatibo | Family Medicine | 850 N Pierce St, Suite D, Lafayette, LA 70501-2848 | 2005-10-07 |
1285972224 | Meredith Preis Lalonde | Occupational Therapist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2013-01-25 |
1982975785 | Jennifer Magee Domengeaux | Speech-Language Pathologist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2012-01-25 |
1265703409 | Mollie Margaret Matthews | Speech-Language Pathologist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2012-01-19 |
1548569668 | Amy Christine Dean | Physical Therapist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2011-03-16 |
1932403003 | Benjamin Dougles Wilson | Physical Therapist | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2011-01-05 |
1144538455 | Carolyn Y. Smith | Physical Medicine & Rehabilitation | 850 N Pierce St, Suite C, Lafayette, LA 70501-2848 | 2010-09-21 |
1609184191 | K and S Therapy | Clinic/Center | 850 N Pierce St, Suite A, Lafayette, LA 70501-2848 | 2010-09-17 |
1518280916 | Pride Plaza | Clinic/Center | 850 N Pierce St, Lafayette, LA 70501-2848 | 2010-03-12 |
1679806178 | Childrens Clinic of Acadiana LLC | Clinic/Center | 850 N Pierce St, Suite F, Lafayette, LA 70501-2848 | 2009-09-15 |
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Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.