1811387673 NPI number — HEALTHSCRIPTS OF AMERICA - SOUTHEAST LOUISIANA, LLC.

Table of content: (NPI 1811387673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811387673 NPI number — HEALTHSCRIPTS OF AMERICA - SOUTHEAST LOUISIANA, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHSCRIPTS OF AMERICA - SOUTHEAST LOUISIANA, 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:
1811387673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6565 WEST LOOP S
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
BELLAIRE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77401-3500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-770-8194
Provider Business Mailing Address Fax Number:
832-770-8196

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2395 GAUSE BLVD E
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
SLIDELL
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70461-6010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-770-8194
Provider Business Practice Location Address Fax Number:
832-770-8196
Provider Enumeration Date:
02/02/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HENRIKSEN
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
832-770-8194

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  PHY.007064-IR , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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