1013310895 NPI number — BARTHELEMY'S OPTICAL, LLC

Table of content: (NPI 1013310895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013310895 NPI number — BARTHELEMY'S OPTICAL, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARTHELEMY'S OPTICAL, 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:
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:
1013310895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1901 MANHATTAN BLVD BLDG D
Provider Second Line Business Mailing Address:
SUITE 121
Provider Business Mailing Address City Name:
HARVEY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70058
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-372-6326
Provider Business Mailing Address Fax Number:
504-336-3160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1901 MANHATTAN BLVD BLDG D
Provider Second Line Business Practice Location Address:
SUITE 121
Provider Business Practice Location Address City Name:
HARVEY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70058-2531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-372-6326
Provider Business Practice Location Address Fax Number:
504-336-3160
Provider Enumeration Date:
10/07/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BARTHELEMY BROWN
Authorized Official First Name:
ANASTASIA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OPHTHALMOLOGY PRACTICE MANAGER
Authorized Official Telephone Number:
504-372-6326

Provider Taxonomy Codes

  • Taxonomy code: 156FC0800X , with the licence number:  151353 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1100X , with the licence number: 151353 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1202X , with the licence number: LDO002099 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 156FX1800X , with the licence number: LDO002099 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207WX0107X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: U18688 , issued by the state of ( GA ) . This identifiers is of the category "MEDICAID".
  • Identifier: LA5335 . This is a "HEALTHCARE PROVIDER" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 2615805858B , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: D8A3E8F5 . This is a "CPT" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 02099 . This is a "LDO" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: GA884 . This is a "OPTOMETRIST" identifier , issued by the state of ( GA ) . This identifiers is of the category "OTHER".
  • Identifier: 151353 . This is a "ABOC" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 151353 . This is a "NCLEC" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: XX1856-79AT . This is a "OPTOMETRIST" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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