NPIMap

Organization Active NPI

Complete Vital Care, Inc.

  • Customized Equipment (DME)
  • Natchitoches, LA
National Provider Identifier
1396769816
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
3763 IR Issued in LA
Legal business name
COMPLETE VITAL CARE, INC.
Practice address
325 Dixie PLZ
Ste B
Natchitoches, LA 71457-5880
Phone
(318) 352-2461
Fax
(318) 357-0778
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
George Gardiner
Title
President
Phone
(318) 352-2461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 3763 IR LA Primary

Addresses

Primary practice location

325 Dixie PLZ
Ste B
Natchitoches, LA 71457-5880

Mailing address

PO Box 5047
Meridian, MS 39302-5047
Phone (800) 447-4095

Other identifiers 1

IdentifierTypeStateIssuer
1266141MedicaidLA

Other names 1

  • Complete Vital Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Complete Vital Care - Shreveport18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Locations

325 Dixie PLZ
Ste B
Natchitoches, LA 71457
Phone (318) 352-2461

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396769816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5047",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393025047",
            "telephone_number": "800-447-4095",
            "fax_number": "601-482-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 DIXIE PLZ",
            "address_2": "STE B",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575880",
            "telephone_number": "318-352-2461",
            "fax_number": "318-357-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE VITAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARDINER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-352-2461"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "LA",
            "license": "3763 IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1266141",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Vital Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Natchitoches, LA

Sources for this page

  • 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.