Provider Demographics
NPI:1366411662
Name:OAC LLC
Entity type:Organization
Organization Name:OAC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR VITALSOURC
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN-TULLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-766-5001
Mailing Address - Street 1:5130 MANCUSO LANE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3583
Mailing Address - Country:US
Mailing Address - Phone:225-766-5001
Mailing Address - Fax:225-766-5001
Practice Address - Street 1:5130 MANCUSO LANE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3583
Practice Address - Country:US
Practice Address - Phone:225-766-5001
Practice Address - Fax:225-766-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA190061363ZOtherBLUE CROSS OF LA
192045Medicare ID - Type Unspecified