Organization
FOUNDATION ANCILLARY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CINDIE PITTMAN (CHIEF EXECUTIVE OFFICES)
(225) 751-3685
Entity
Organization
Contact information
Practice address
17617 S HARRELLS FERRY RD, BATON ROUGE, LA 70816-3532
(225) 751-3685
(225) 753-0948
Mailing address
17617 S HARRELLS FERRY RD, BATON ROUGE, LA 70816-3532
(225) 751-3685
(225) 753-0948
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03632301
—
MS
05
—
1018334880001
—
PA
05
—
1454214
—
LA
Enumeration date
06/13/2006
Last updated
10/02/2007
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