1205846821 NPI number — SAVOY MEDICAL CENTER

Table of content: (NPI 1205846821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205846821 NPI number — SAVOY MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAVOY MEDICAL CENTER
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:
1205846821
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:
801 POINCIANA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAMOU
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70554-2243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-468-0423
Provider Business Mailing Address Fax Number:
337-468-0451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 POINCIANA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAMOU
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70554-2243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-468-0423
Provider Business Practice Location Address Fax Number:
337-468-0451
Provider Enumeration Date:
08/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BELLARD
Authorized Official First Name:
ROBIN
Authorized Official Middle Name:
Authorized Official Title or Position:
ASST. BUSINESS OFFICE DIRECTOR
Authorized Official Telephone Number:
337-468-0423

Provider Taxonomy Codes

  • Taxonomy code: 282NR1301X , 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: C8594 . This is a "BLUE CROSS PHYSICIANS" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 61300 . This is a "BLUE CROSS PSYCHE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 61301 . This is a "BLUE CROSS REHAB" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1766062 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1796590 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 61299 . This is a "BLUE CROSS ACUTE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1705772 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com