1497785299 NPI number — LOUISIANA MOBILITY OF CENTRAL LA, INC

Table of content: (NPI 1497785299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497785299 NPI number — LOUISIANA MOBILITY OF CENTRAL LA, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUISIANA MOBILITY OF CENTRAL LA, 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:
ZURCARE
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:
1497785299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5508 MONROE HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALL
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-640-0988
Provider Business Mailing Address Fax Number:
318-640-0927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5508 MONROE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALL
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-640-0988
Provider Business Practice Location Address Fax Number:
318-640-0927
Provider Enumeration Date:
07/04/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARRISON
Authorized Official First Name:
FRANCES
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/OWNER
Authorized Official Telephone Number:
601-914-1004

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0198150-001 , 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)

  • Identifier: F2986 . This is a "BLUE CROSS OF LA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1544639 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".