Bayou Healthcare Services, Llc | |
108 E 11th St. Thibodaux LA 70301 | |
(985) 228-6223 | |
Not Available |
Full Name | Bayou Healthcare Services, Llc |
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Speciality | Clinic/Center |
Location | 108 E 11th St., Thibodaux, Louisiana |
Authorized Official Name and Position | Brittany Trosclair Mire (OWNER) |
Authorized Official Contact | 9852286223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bayou Healthcare Services, Llc 213 Saint Mary St Ste 218 Thibodaux LA 70301-2634 Ph: () - | Bayou Healthcare Services, Llc 108 E 11th St. Thibodaux LA 70301 Ph: (985) 228-6223 |
NPI Number | 1033999040 |
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Provider Enumeration Date | 10/05/2023 |
Last Update Date | 11/30/2024 |
Medicare PECOS PAC ID | 4385179589 |
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Medicare Enrollment ID | O20241125003291 |
Identifier | Type | State | Issuer |
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1033999040 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Brittany Mire |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093251472 PECOS PAC ID: 2668757469 Enrollment ID: I20170317000804 |
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