1669649125 NPI number — CARING HANDS & HEART LLC

Table of content: MR. KARL MARK DUNLAP RN (NPI 1629180021)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669649125 NPI number — CARING HANDS & HEART LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARING HANDS & HEART LLC
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:
Provider Other Organization Name Type Code:
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:
1669649125
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1061
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BASTROP
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71221-1061
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-281-0014
Provider Business Mailing Address Fax Number:
318-281-0208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5491 NAFF ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BASTROP
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-281-0014
Provider Business Practice Location Address Fax Number:
318-281-0208
Provider Enumeration Date:
05/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RAYFORD
Authorized Official First Name:
AUDREY
Authorized Official Middle Name:
DELOSHA
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
318-281-0014

Provider Taxonomy Codes

  • Taxonomy code: 372500000X , with the licence number:  PCA 6942 , 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: 1509035 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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