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Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Organization
THIBODAUX REGIONAL NETWORK DEVELOPMENT CORPORATION
Active
Other names
Thibodaux Regional Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIM LEGENDRE BOUDREAUX (DIRECTOR OF CONTRACTING)
(985) 493-4907
Entity
Organization
Contact information
Practice address
2031 AUDUBON AVE, THIBODAUX, LA 70301-5073
(985) 493-4907
Mailing address
602 N. ACADIA RD, ATTN: CONTRACT MNGT DEPT., THIBODAUX, LA 70301
(985) 493-4907
(985) 449-2585
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
Other
Enumeration date
06/21/2024
Last updated
07/26/2024
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