Provider Demographics
NPI:1215126784
Name:THE ELDERS, INC.
Entity type:Organization
Organization Name:THE ELDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ANGELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-332-4808
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-0010
Mailing Address - Country:US
Mailing Address - Phone:337-332-4808
Mailing Address - Fax:337-332-2897
Practice Address - Street 1:606 LATIOLAIS DR
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-4231
Practice Address - Country:US
Practice Address - Phone:337-332-4808
Practice Address - Fax:337-332-2897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332BP3500X332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0463390001Medicare NSC