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Organization
TRPP-ACO LLC
Active
Organization
TRPP-ACO LLC
Active
Parent organization
THIBODAUX REGIONAL HEALTH SYSTEM INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
THIBODAUX REGIONAL HEALTH SYSTEM INC
Authorized official
KIM LEGENDRE BOUDREAUX MBA (EXECUTIVE DIRECTOR)
(985) 449-2585
Entity
Organization
Contact information
Practice address
602 N. ACADIA ROAD, THIBODAUX, LA 70301
(985) 493-4907
(985) 449-2585
Mailing address
602 N. ACADIA ROAD, THIBODAUX, LA 70301
(985) 493-4907
(985) 493-2585
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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