Provider Demographics
NPI:1306426135
Name:START CORPORATION
Entity type:Organization
Organization Name:START CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-879-3966
Mailing Address - Street 1:235 CIVIC CENTER BLVD STE 136
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-5937
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:235 CIVIC CENTER BLVD STE 136
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5937
Practice Address - Country:US
Practice Address - Phone:985-333-2020
Practice Address - Fax:985-851-0162
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:START CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy