Organization
ASSURED MEDICAL GROUP, INC
Active
Parent organization
ASSURED MEDICAL HOLDINGS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASSURED MEDICAL HOLDINGS, INC
Authorized official
MR. THOMAS L EWING (EXECUTIVE DIRECTOR)
(337) 334-7031
Entity
Organization
Contact information
Practice address
200 AMERICAN LEGION DR, RAYNE, LA 70578-5826
(337) 334-7031
(225) 208-1415
Mailing address
139B JAMES COMEAUX RD # 575, LAFAYETTE, LA 70508-3255
(337) 334-7031
(225) 208-1415
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
PCA 15206
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PCA 82
—
LA
Enumeration date
06/30/2009
Last updated
06/30/2009
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