Moss Street Kid Med Llc

LBN: Moss Street Kid Med Llc
Moss Street Kid Med Llc is an health care organization with primary practice located at 1417A Moss Street , Lafayette LA 70501. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Moss Street Kid Med Llc can be contacted via phone (337) 291-2411, or through Richard, Desiree P via phone (337) 291-2411.

Contact Information

Primary practice address
1417A Moss Street Lafayette LA 70501
Phone: (337) 291-2411
Fax: (337) 291-2412
Website:
Map and Directions
Authorized official contact:
Name: Richard, Desiree P Registered Nurse (RN)
Phone: (337) 291-2411

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X Louisiana

Profile Details

NPI number 1336268184
LBN Legal business name Moss Street Kid Med Llc
DBA Doing business as
Authorized official Richard, Desiree P Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2007
Last updated Mar 25th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336268184 NPPES
Louisiana MEDICAID 1949221

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