Organization
COMMCARE LOUISIANA
Active
Parent organization
COMMCARE LOUISIANA
Other names
d/b/a Home Infusion and DME Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMCARE LOUISIANA
Authorized official
MR. JOHN A. STASSI II (SECRETARY AND DIRECTOR)
(504) 324-8950
Entity
Organization
Contact information
Practice address
5201A SHREVEPORT HIGHWAY, PINEVILLE, LA 71360
(318) 640-2030
(318) 640-4927
Mailing address
4020 GREEWOOD ROAD, SHREVEPORT, LA 71109-0000
(318) 631-1466
(318) 631-9466
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2730984-001
LA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
30440-011-0-2010
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1473715
—
LA
05
—
1677531
—
LA
Enumeration date
01/02/2007
Last updated
04/11/2011
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