Ponchatoula Nursing Home, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PONCHATOULA NURSING HOME, LLC

Practice address

15704 Medical Arts Dr
Hammond, LA 70403-1446

Phone

(985) 542-0110

NPI assigned

Apr 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul Guitreau

Title

Owner

Phone

(985) 542-0110

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003030800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13524",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713153524",
            "telephone_number": "318-445-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15704 MEDICAL ARTS DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031446",
            "telephone_number": "985-542-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCHATOULA NURSING HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUITREAU",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-542-0110",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1163163",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "34086",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andee Marie Poche, DC
• Sara Elizabeth Pohlman, AU.D.
• Blaise V Polito, D.D.S.
• Patricia Ann Polito, BACHERLORS
• Joseph Pomaville, MD
• Ponchatoula Nursing Home, LLC
• Pontchartrain Cancer Center Inc
• Carol Ann Pooley, MSW, LCSW
• Gelise Marie Porter, DDS
• Marya Jancinta Porter, M.D.

• Durable Medical Equipment & Medical Supplies in Hammond, LA
• Providers in Hammond, LA by specialty
• Durable Medical Equipment & Medical Supplies in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.