1184928368 NPI number — JARDEX INC

Table of content: (NPI 1184928368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184928368 NPI number — JARDEX INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JARDEX 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:
DOCTORS EXPRESS METAIRIE
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:
1184928368
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1530 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70130-5816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-561-0792
Provider Business Mailing Address Fax Number:
504-581-1073

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3348 W ESPLANADE AVE S
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70002-3475
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-832-2244
Provider Business Practice Location Address Fax Number:
504-832-0044
Provider Enumeration Date:
01/03/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PIGOTT
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
DOUGLAS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
504-874-6100

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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