1659309201 NPI number — VACHERIE DIALYSIS CENTER, INC.

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 1659309201 NPI number — VACHERIE DIALYSIS CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VACHERIE DIALYSIS CENTER, 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:
1659309201
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4424 CONLIN ST
Provider Second Line Business Mailing Address:
SUITE 2A
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70006-2147
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-780-1422
Provider Business Mailing Address Fax Number:
504-780-1432

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2504 HWY. 20
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
VACHERIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-265-9030
Provider Business Practice Location Address Fax Number:
225-265-7070
Provider Enumeration Date:
06/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HATIPOGLU
Authorized Official First Name:
MURAT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
504-780-1422

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X , with the licence number:  084 , 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: 34655 . This is a "BLUE CROSS BLUE SHIELD LA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1681407 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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