Organization
CARROLL NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA COX REARDON (OWNER)
(318) 428-3249
Entity
Organization
Contact information
Practice address
307 N CASTLEMAN STREET, OAK GROVE, LA 71263
(318) 428-3249
(318) 428-7547
Mailing address
PO BOX 13524, ALEXANDRIA, LA 71315-3524
(800) 815-0586
(318) 445-9433
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
165
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1549304
—
LA
01
—
F3410
BLUE CROSS BLUE SHIELD
LA
Enumeration date
04/11/2007
Last updated
08/22/2020
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