1588879878 NPI number — TULANE MEDICAL CENTER ADMINISTRATORS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588879878 NPI number — TULANE MEDICAL CENTER ADMINISTRATORS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TULANE MEDICAL CENTER ADMINISTRATORS
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:
1588879878
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:
1430 TULANE AVE
Provider Second Line Business Mailing Address:
TW22
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70112-2632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-988-2300
Provider Business Mailing Address Fax Number:
504-988-3969

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5352 HOSPITAL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PINEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-988-2300
Provider Business Practice Location Address Fax Number:
504-988-3969
Provider Enumeration Date:
05/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
RITA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, TULANE UNIV MEDICAL GROUP
Authorized Official Telephone Number:
504-988-3587

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1443280 . This is a "LA MCAID GRP PROVIDER #" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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