Organization Name: | BIO-MEDICAL APPLICATIONS OF LOUISIANA, LLC |
NPI Number: | 1114126737 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK FAWCETT (TREASURER) |
Mailing Address: | 137 Veterans Blvd Denham Springs |
State: | LA US |
Postal Code: | 707265130 |
Phone Number: | 2256652796 |
Fax Number: | 2256656329 |
NPI Enumeration Date: | 07/13/2007 |
NPI Last Update Date: | 02/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |