1619162245 NPI number — HEALTHFIRST SPECIALTIES, P.A.

Table of content: (NPI 1619162245)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619162245 NPI number — HEALTHFIRST SPECIALTIES, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHFIRST SPECIALTIES, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WELLNESS IN MOTION CHIROPRACTIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619162245
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70452 HIGHWAY 21
Provider Second Line Business Mailing Address:
SUITE 200-161
Provider Business Mailing Address City Name:
COVINGTON
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70433-8116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-871-1189
Provider Business Mailing Address Fax Number:
985-871-1184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
187 GREENBRIAR BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70433-7234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-871-1189
Provider Business Practice Location Address Fax Number:
985-871-1184
Provider Enumeration Date:
09/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAMBURGER
Authorized Official First Name:
LORENZ
Authorized Official Middle Name:
WOLF
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
512-659-8777

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1595 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 1376 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8R5278 AND 0045MC . This is a "BCBS (IND# AND GRP#)" identifier . This identifiers is of the category "OTHER".




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