Organization
SWAMP ELITE RETREAT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRINA HAYNES (DIRECTOR)
(985) 467-0888
Entity
Organization
Contact information
Practice address
46424 RUFUS BANKSTON RD STE 100, HAMMOND, LA 70401-6108
(985) 467-0888
Mailing address
PO BOX 631, PONCHATOULA, LA 70454-0631
(985) 467-0888
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
04/06/2019
Last updated
05/06/2024
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