Provider Demographics
NPI:1194165654
Name:LA DEPARTMENT OF HEALTH AND HOSPITALS
Entity type:Organization
Organization Name:LA DEPARTMENT OF HEALTH AND HOSPITALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-342-9500
Mailing Address - Street 1:628 N 4TH ST
Mailing Address - Street 2:BIN 3
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-5342
Mailing Address - Country:US
Mailing Address - Phone:225-342-9500
Mailing Address - Fax:
Practice Address - Street 1:628 N. FOURTH STREET
Practice Address - Street 2:BIN 3
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802
Practice Address - Country:US
Practice Address - Phone:225-342-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LANONE251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2157787Medicaid