Provider Demographics
NPI:1124849625
Name:THE LULA CONNECTION LLC
Entity type:Organization
Organization Name:THE LULA CONNECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-804-2075
Mailing Address - Street 1:2173 HIGHLAND AVE S APT H1409
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-4061
Mailing Address - Country:US
Mailing Address - Phone:586-804-2075
Mailing Address - Fax:
Practice Address - Street 1:331 25TH ST W
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-5828
Practice Address - Country:US
Practice Address - Phone:205-384-9086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty