Organization
UROSOURCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARISSA KERNER FALTER (OWNER/MANAGER)
(337) 739-2239
Entity
Organization
Contact information
Practice address
401 AUDUBON BLVD, SUITE 209, LAFAYETTE, LA 70503
(337) 739-2239
(337) 266-9598
Mailing address
127 S. SOUTHLAWN DR, LAFAYETTE, LA 70503-3337
(337) 739-2239
(337) 266-9598
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1706159
—
LA
Enumeration date
07/06/2006
Last updated
09/04/2009
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