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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