Organization
MCO OF LOUISIANA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIXIE RENEE MEYERS (MANAGER)
(318) 628-6900
Entity
Organization
Contact information
Practice address
430 WEST SOUTH STREET, WINNFIELD, LA 71483
(318) 628-6900
(318) 628-6111
Mailing address
PO BOX 909, 430 WEST SOUTH STREET, WINNFIELD, LA 71483
(318) 628-6900
(318) 628-6111
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1930351
—
LA
Enumeration date
11/15/2006
Last updated
11/07/2007
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