1053711887 NPI number — TRANSAFRICAN DEVELOPMENT, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053711887 NPI number — TRANSAFRICAN DEVELOPMENT, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSAFRICAN DEVELOPMENT, INC.
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:
JEFFERSON DAVIS RURAL CLINIC
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:
1053711887
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1015
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE CHARLES
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70602-1015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-292-8739
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 PALMER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELSH
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70591-4320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-292-8739
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2014

Additional Information

Authorized Official

Authorized Official Last Name:
NDANDO-NGOO
Authorized Official First Name:
VICTOR
Authorized Official Middle Name:
ELOKAN
Authorized Official Title or Position:
FOUNDER/CEO
Authorized Official Telephone Number:
713-292-8739

Provider Taxonomy Codes

  • Taxonomy code: 261QD0000X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0850X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QP2300X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR1300X , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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