1730311440 NPI number — MEDICAL TEMPS, INC

Table of content: ROCHELLE JEANNINE BAXTER GREEN (NPI 1447684022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730311440 NPI number — MEDICAL TEMPS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL TEMPS, 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:
1730311440
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 MCMILLAN RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
WEST MONROE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71291-7885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-651-4455
Provider Business Mailing Address Fax Number:
318-651-4457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 MCMILLAN RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
WEST MONROE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71291-7885
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-651-4455
Provider Business Practice Location Address Fax Number:
318-651-4457
Provider Enumeration Date:
08/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ALLBRITTON
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
CALHOUN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
318-651-4455

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X , with the licence number:  1885 SLP , 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: 1740307750 . This is a "MEDICARE PART B" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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