1942209457 NPI number — ANESTHESIA EAST INC

Table of content: (NPI 1942209457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942209457 NPI number — ANESTHESIA EAST INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIA EAST 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:
MEDICAL BILLING COMPANY OF LOUISIANA
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:
1942209457
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9830 LAKE FOREST BLVD
Provider Second Line Business Mailing Address:
STE 111
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70127-5455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-241-4832
Provider Business Mailing Address Fax Number:
504-242-4984

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5620 READ BLVD
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:
70127-3106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-241-4832
Provider Business Practice Location Address Fax Number:
504-241-4832
Provider Enumeration Date:
07/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SAMM
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
HEAD ANESTHESIOLOGIST
Authorized Official Telephone Number:
504-241-4832

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  102549 , 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: 01323 . This is a "BLUE CROSS" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1793442 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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