1003986365 NPI number — CELINE H LEMIEUX DC

Table of content: CELINE H LEMIEUX DC (NPI 1003986365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003986365 NPI number — CELINE H LEMIEUX DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEMIEUX
Provider First Name:
CELINE
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLLINS
Provider Other First Name:
CELINE
Provider Other Middle Name:
LEMIEUX
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003986365
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1525 LAPALCO BLVD
Provider Second Line Business Mailing Address:
SUITE 12
Provider Business Mailing Address City Name:
HARVEY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70058-5738
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-227-0272
Provider Business Mailing Address Fax Number:
504-227-0275

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1525 LAPALCO BLVD
Provider Second Line Business Practice Location Address:
SUITE 12
Provider Business Practice Location Address City Name:
HARVEY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70058-5738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-227-0272
Provider Business Practice Location Address Fax Number:
504-227-0275
Provider Enumeration Date:
11/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  655 , 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: G3788 . This is a "BLUE CROSS PROVIDER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 721236014 . This is a "TAX IDENTIFICATION NUMBER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1951081 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 350049748 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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