1598034332 NPI number — CARE ONE HEALTH LLC

Table of content: (NPI 1598034332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598034332 NPI number — CARE ONE HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE ONE HEALTH 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:
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:
1598034332
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4919 JAMESTOWN AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70808-3228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-923-2090
Provider Business Mailing Address Fax Number:
225-282-1004

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
522 MARTIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIBERTY
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39645-6061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-353-4580
Provider Business Practice Location Address Fax Number:
225-282-1004
Provider Enumeration Date:
12/23/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BATISTE
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
225-923-2090

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000002 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com