1194064469 NPI number — HARVEST LABS, INC.

Table of content: KATHRYN MAY MCKINNEY RDN, CDCES (NPI 1639104490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194064469 NPI number — HARVEST LABS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARVEST LABS, 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:
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:
1194064469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1563
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CROWLEY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70527-1563
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-376-2999
Provider Business Mailing Address Fax Number:
337-376-2999

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
730 N AVENUE K
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
CROWLEY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70526-3849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-376-2999
Provider Business Practice Location Address Fax Number:
337-376-2999
Provider Enumeration Date:
02/06/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LELEUX
Authorized Official First Name:
TODD
Authorized Official Middle Name:
M
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
337-376-2999

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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