1730202110 NPI number — CONTEMPORORY FAMILY HEALTH CENTERS, INC.

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 1730202110 NPI number — CONTEMPORORY FAMILY HEALTH CENTERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONTEMPORORY FAMILY HEALTH CENTERS, 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:
Provider Other Organization Name Type Code:
6
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:
1730202110
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/21/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2475 CANAL STREET
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70119
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-822-8262
Provider Business Mailing Address Fax Number:
504-822-8264

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2426 SIMON BOLIVAR
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:
70113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-571-1607
Provider Business Practice Location Address Fax Number:
504-571-1609
Provider Enumeration Date:
04/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LANGIE
Authorized Official First Name:
BURNELL
Authorized Official Middle Name:
G
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
504-822-8262

Provider Taxonomy Codes

  • Taxonomy code: 261QC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1155381 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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