Lafourche Ambulance District No. 1

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

9110022 Issued in LA

Legal business name

LAFOURCHE AMBULANCE DISTRICT NO. 1

Practice address

17078 W Main St
Cut Off, LA 70345-4102

Phone

(985) 632-7192

Fax

(985) 632-7198

NPI assigned

Jun 30, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah G. Gautreaux

Title

Administrator

Phone

(985) 632-7192

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457358996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17078 W MAIN ST",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454102",
            "telephone_number": "985-632-7192",
            "fax_number": "985-632-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17078 W MAIN ST",
            "city": "CUT OFF",
            "state": "LA",
            "postal_code": "703454102",
            "telephone_number": "985-632-7192",
            "fax_number": "985-632-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFOURCHE AMBULANCE DISTRICT NO. 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAUTREAUX",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "985-632-7192",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "LA",
            "license": "9110022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1193925",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lafourche Parish Hospital Service District No. 1
• Lafourche Parish Hospital Service District No. 1 (Lady of the Sea Medical Clinic - Cut Off)
• Lafourche Parish Hospital Service District No.1 (Lady of the Sea General Hospital)

• Land Ambulance in Cut Off, LA
• Providers in Cut Off, LA by specialty
• Land Ambulance 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.