1689931552 NPI number — ACCESS HEALTH LOUSISANA

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 1689931552 NPI number — ACCESS HEALTH LOUSISANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS HEALTH LOUSISANA
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:
BELLE CHASSE CHC GNOCHC
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:
1689931552
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 INDIANA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KENNER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70065-4605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-575-3712
Provider Business Mailing Address Fax Number:
504-575-3691

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8200 HIGHWAY 23
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLE CHASSE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70037-2607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-398-1100
Provider Business Practice Location Address Fax Number:
504-575-3691
Provider Enumeration Date:
04/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KEISER
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
504-575-3700

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , 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: 2195743 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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