1528014164 NPI number — ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND

Table of content: (NPI 1528014164)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528014164 NPI number — ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADMINISTRATORS OF THE TULANE EDUCATIONAL FUND
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:
TULANE UNIVERSITY MEDICAL GROUP
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:
1528014164
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1430 TULANE AVE # 8422
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:
70112-2632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-988-2300
Provider Business Mailing Address Fax Number:
504-988-3969

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1415 TULANE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-988-2300
Provider Business Practice Location Address Fax Number:
504-988-3969
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
RITA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, TULANE UNIV BUS SERVICES
Authorized Official Telephone Number:
504-988-6855

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 09015509 . This is a "MS MEDICAID" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1167819 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 529301530 . This is a "AL MEDICAID" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 012915600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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