Provider Demographics
NPI:1366710345
Name:VENTURE MEDICAL LLC
Entity type:Organization
Organization Name:VENTURE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:RATCLIFF
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-228-2626
Mailing Address - Street 1:212 BAYOU LN
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3621
Mailing Address - Country:US
Mailing Address - Phone:985-228-2626
Mailing Address - Fax:
Practice Address - Street 1:212 BAYOU LN
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3621
Practice Address - Country:US
Practice Address - Phone:985-228-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies