1922193911 NPI number — BATON ROUGE NEONATAL ASSOCIATES, 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 1922193911 NPI number — BATON ROUGE NEONATAL ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BATON ROUGE NEONATAL ASSOCIATES, 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:
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:
1922193911
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 RUE DE LA VIE ST
Provider Second Line Business Mailing Address:
SUITE 405
Provider Business Mailing Address City Name:
BATON ROUGE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70817-5127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-928-2555
Provider Business Mailing Address Fax Number:
225-929-9685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 RUE DE LA VIE ST
Provider Second Line Business Practice Location Address:
SUITE 405
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70817-5127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-928-2555
Provider Business Practice Location Address Fax Number:
225-929-9685
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPEDALE
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
BRIAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
225-928-2555

Provider Taxonomy Codes

  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1942171 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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