Provider Demographics
NPI:1295086213
Name:M.E.C.U,LLC
Entity type:Organization
Organization Name:M.E.C.U,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:FUDESCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-264-2267
Mailing Address - Street 1:18092 MANNING DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-5626
Mailing Address - Country:US
Mailing Address - Phone:985-264-2267
Mailing Address - Fax:225-246-8059
Practice Address - Street 1:18092 MANNING DR
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-5626
Practice Address - Country:US
Practice Address - Phone:985-264-2267
Practice Address - Fax:225-246-8059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty